Friday, June 15, 2007

RHIOs still a tough row to hoe

This week's GovernmentHealthIT reports the dissolution of the Northeastern Pennsylvania Regional Health Information Organization ("Pennsylvania RHIO to close"). This follows on the demise of the Santa Barbara County Care Data Exchange. In the coming weeks another relatively high profile effort will announce their decision to dissolve.

There are over 200 HIE efforts across the country, most still burning through their initial grant funding, trying to find the elusive "sustainability" model. None have yet been able to replicate the successes of the only self-sustaining efforts to date: Indiana Health Information Exchange, HealthBridge, and MA-SHARE.

It's worth noting that the lines of business that have made these efforts sustainable so far haven't been about ubiquitious sharing of data, per se; success in these efforts has come from creating a single "pipeline" that efficiently channels disparate streams of data. The successful product/service areas have used technology to create economies of scale in basic backoffice functions, and collaboration to convince participants to outsource these functions to the "RHIO".

This general model can be replicated in many other places, so there's still plenty of opportunity out there, but it's not a universally applicable solution. Making this model work in other places where it fits, and establishing other value-generating product/service areas where the model doesn't fit, will be key to getting more RHIOs firmly in the win column.


Sachi said...

Hi Micky,

What do you think of the "push" form of data exchange - directed delivery of clinical information from provider to provider? Do you feel it is a sustainable model - if so, which use cases do you think have most value, from your experience in managing 3 HIEs?


Dave S. said...

If you check out the Indiana web site, you will see that they use a "push" model for clinical messaging. MA-SHARE is in the process of developing a push service for some use cases, too. I'll leave it to Micky to comment on his experience from the community HIEs.