JAMIA: Characteristics associated with Regional Health Information Organization viability
In January 2010 issue of JAMIA, the original research paper titled “Characteristics associated with Regional Health Information Organization viability” by Julia Adler-Milstein, John Landefeld, and Ashish K Jha concludes “Our work suggests that RHIOs find a broad group of stakeholders and begin with a narrow set of activities to help them get off the ground. Further, we believe that judicious use of grants, possibly through ‘matching’ mechanisms where stakeholders are also asked to contribute early, will help to ensure that RHIOs become viable and self-sustaining.”
As Joseph Goedert reported Dec 17, 2009 in HealthData Management article titled “What Makes HIEs Viable?” “Results from a national survey of regional health information organizations show simplicity and early funding commitments from participants improve viability of the initiatives.”
A December 2007 study in Health Affairs by two of the same Harvard authors examining “The State Of Regional Health Information Organizations: Current Activities And Financing” found “a substantial number of early failures, stalled efforts, and RHIOs that were heavily dependent on grants.”
Mike, as was referenced by Goedert in his article, despite the negative tenor of the Dec 2007 study by the Harvard authors, we are in fact seeing a much more stable environment for HIE initiatives to develop as of 2009. The eHealth Initiative’s 2009 HIE survey found that a record 57 initiatives considered themselves operational, and that there was a large pool of initiatives at stage 4 on our 7-stage scale, which means that they are on the cusp of exchanging health information (versus being in the planning stages). With the large amount of money flowing from HHS to states to promote HIE within each state, and the further development of the NHIN, it is an exciting time to be pursuing HIE. We still have a long way to come, but orgs. like the Indiana Health Information Exchange, HealthBridge, and others are showing that it is possible to have a sustainable business model despite the lack (for the moment) of proper incentives in the broader health care system.
Brian, The JAMIA article is useful in providing some guiding principles for developing health information exchange–to start with narrow focus on data to be exchanged initially, to ask broad group of stakeholders to commit financially, and to set time horizons relatively short. Focus is on getting things done and building incrementally on solid progress.
Mike Squires