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Only 13 RHIOs Meet Meaningful Use Criteria

Margaret Dick Tocknell, for HealthLeaders Media, May 17, 2011

None of the 75 RHIOs met the criteria for the comprehensive information exchange needed to substantially improve healthcare quality and efficiency.

This is the third time the researchers have looked at this topic with similar results.

"The goal is to quickly build a technical infrastructure but states, RHIOs and any other organizations they partner with really have their work cut out for them," says Adler-Milstein.

According to the report, funding for RHIOs may be part of the problem. Substantial start-up money comes from the public sector, but eventually RHIOs are expected to find stakeholders willing to pay for the value they create and to become self-sustaining. This encourages RHIOs to "focus on a narrow set of transactions with clear value to providers (such as exchange of test results) as opposed to a broader data exchange that might offer more substantial benefits," the report says.

Among the 75 operational RHIOs, 25 were financially viable (able to cover operating expenses with revenues from the hospitals and physician groups that participate in the RHIO). About 40% of the operational RHIOs that said they weren't financially viable reported that they expected to become financially viable in the future. Of the 13 RHIOs that could support meaningful use, six were financially viable.

Despite the drawbacks, Adler-Milstein says that with the right tools in place states may find that a RHIO still offers a good starting point for building out their HIE because RHIOs already have the infrastructure in place to share information. The challenge, she says, is to create a sustainable business model for RHIOs where there hasn't been one before. That means states must put in place policies and incentives that encourage RHIOs to expand their services and the range of HIE that they support.

Adler-Milstein says "we need to strengthen the use cases for HIE. We've been pushing the technology first when we really should emphasize the comprehensive patient information that is available at the point of care. That's what will really drive the success of RHIOs."

None of the 75 RHIOs met the criteria for the comprehensive information exchange needed to substantially improve healthcare quality and efficiency.

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2 comments on "Only 13 RHIOs Meet Meaningful Use Criteria"


A. Jan Berlin M.D. (5/25/2011 at 10:40 AM)
It would be helpful to be able to identify the 13 RHIOs that meet the basic criteria without going the the Annals website where one must be a member to view the article cited.

Doug Dietzman (5/20/2011 at 8:45 PM)
I reject the premise of the article and research that suggests a RHIO must meet the wide ranging MU requirements. A RHIO is not an office EMR or clinical data repository nor does it need to provide either one to be a successful RHIO. RHIOs should not be held responsible for actual clinical redesign and care delivery change any more than the claim clearinghouses on the administrative side should be held accountable for revenue cycle redesign or performance within the companies that use them to transact data. RHIOs are not the sole 100% answer to everything needed for MU even though they play a critical role in supporting some of them. Perhaps that is why so many RHIOs find it difficult to get started and remain sustainable because the expectations are unrealistic as to the overall role they play and they try to be all things to all people. RHIOs can make sure data the right data gets where it needs to be when it needs to be there. What the clinicians and other users do with that data has everything to do with whether the patient care and wellness needles move in a positive direction or not. The clinicians must demonstrate meaningful use of technology, a portion of which is served by successful RHIOs.