Ignoring the Skeptics

Gary Baldwin, for HealthLeaders Media, January 21, 2008
Several recent studies and surveys suggest growing skepticism about the longevity of regional health information organizations, aka "RHIOs." Nearly 70 percent of respondents to our own recent unscientific online poll agreed that most RHIOs will cease operations within the near future. Although most people understand the importance of data sharing across competitive organizations, many are wondering if the multitude of RHIOs will have staying power. Financial and governance issues--not the technological capability in play--are often cited as stumbling blocks.

I have been fascinated and mystified over the sheer number of RHIOs that have sprung up in the last few years. It's as if someone waved a wand over the country and said, "Let's set up healthcare data exchanges." I suppose you could argue that this someone is George Bush, whose call to action on EMRs a few years back (supplemented by enhanced federal visibility and grant money) may have prompted all the action.

Despite the growing doubts, RHIO organizers are continuing to push forward. Last week, I sat in on a press conference staged by HealthInfoNet, a Maine-based data exchange that is just getting under way. HealthInfoNet is launching a 24-month demonstration project that includes 15 hospitals and more than one-third of the practicing physicians in the state. The primary vendor partner is 3M, which is providing interoperability technology, the clinical data repository, and the master patient index. To sidestep the inevitable privacy issues, the exchange will grant patients the ability to completely opt out of the exchange, in essence making their data off-limits. Now that's a preemptive strike against paranoia! It could backfire, I suppose, if enough people were scared off by the prospects of their medical record traversing a state-wide electronic network.

The group has secured $4 million out of the $6 million it says it will need to complete the effort. Half of that money has come from foundations, with the rest from business, providers, government, and--are you ready for this?--payers (health plans have anted up a whopping 1 percent of the budget so far). Exactly where the rest of the budget will come from is unclear, although the exchange's leaders do understand the importance of a sustainable business model. By sharing medication lists, lab values, and other clinical reports, the exchange hopes to improve care and reduce costs by eliminating the redundant testing that plagues the industry. "We have huge potential to reduce cost," said Chuck Hewitt, chief operating officer at Jackson Laboratory, Bar Harbor and a member of the HealthInfoNet board of directors.

Few might challenge that assumption. Making it come to life, however, is another issue. The state of Maine is about to become a highly visible test case.

Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at gbaldwin@healthleadersmedia.com.
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