RHIO

California RHIO backed by high-powered employer

Mon, 28 Apr 2008 06:59:55 -0400

As regular readers know, I regularly lambaste RHIOs/HIEs, most of which appear to have little chance of financial survival. However, when it comes to a RHIO that attracts the support of a giant like the California Public Employees' Retirement System (CalPERS), I think we're looking at a breakthrough. This week, CalPERS said that it would support the statewide RHIO being developed by the California Regional Health Information Organization (CalRHIO). CalPERS, which serves 1.2 million state and local public employees, retirees and dependants, has asked its health insurers to establish contracts with CalRHIO. These include Anthem Blue Cross, Blue Shield of California and Kaiser Permanente. Now, there's no way to tell just how much money the payers will shell out--and how long the deals will last--but it's definitely a start. I'll be keeping my eye on this one. Any RHIO that has a big employer's backing has a much better chance of success.

To learn more about this deal:
- read this Health Data Management article

Related Articles:
Long-lived California RHIO shuts down
Free, open source RHIO software coming
Why RHIOs shouldn't exist
Study: RHIOs aren't doing so well

SPOTLIGHT: Exec argues that EMRs show quality commitment

Mon, 28 Apr 2008 06:59:52 -0400

Many of the biggest supporters of EMR adoption pitch them as a huge productivity improvement tool. But to Laura Adams, president and CEO of the Rhode Island Quality Institute, they're central to improving quality, too. Her organization, which hosts the state's RHIO, is built on the notion that not having having access to digital health information causes harm, not just delays or waste. Article

Study: More providers joining HIEs

Mon, 21 Apr 2008 06:59:54 -0400

While the process is slow, it appears that more healthcare providers are gradually linking up with health information exchanges, according to a new study released by IDC-HII. For example, 15 percent of hospital respondents to one IDC-HII survey said they were participating in an HIE, and 35 percent more said they were in active discussions to do so. Meanwhile, in a February 2008 IDC-HII poll of community hospital CIOs, 22.7 percent said their health system was participating in an HIE, 18.2 percent planned to do so within less than a year, and 27.3 percent were considering the HIE option. One side note was that 33 percent of the CIOs who were involved in an HIE said they were part of a "proprietary HIE," one tied to a sponsor such as an integrated delivery network. To me, this suggests that while HIE penetration may be growing, the national health information network remains painfully far from being realized.

To learn more about IDI-HII's research:
- read this Healthcare IT News piece

Related Articles:
Joint Commission calls for national HIE
Study: RHIOs/HIEs backed by states will win
Report offers HIE keys to survival
What is the business model for sustaining a RHIO?

HIT terms becoming more defined

Mon, 31 Mar 2008 07:59:56 -0400

Do you know the difference between an e-medical record and an e-health record? Health IT professionals are banking on an answer of "no," which is why there now is more of a push to give more "precise definitions" to oft used HIT terms, according to an article in Government Health IT. For example, a health information exchange (HIE) should not be defined as any sort of organization, but rather the act of exchanging health information. Furthermore, a HIE org for, say, orthopedic surgeons nationwide, should not be referred to as a regional health information organization (RHIO) because it spans more than just a single region.

So what is the difference between an EMR and an EHR? According to project leaders at the National Alliance for Health IT, an EMR "is created and maintained by people from one organization, such as a hospital." An EHR, on the other hand, "is an aggregate of health records from more than one healthcare organization."

For more information:
- read the full article

RHIO/HIE solutions emerge

Thu, 21 Feb 2008 06:59:55 -0500

While RHIOs and HIEs might be having trouble getting their act together, it's not for lack of technology options. In fact, they'll find a pretty rich set of solutions to check out at HiMSS, including some that weren't available at last year's big show. Increasingly, the move seems to be to put a simple Web interface on disparate data systems rather than go for higher levels of integration--which makes a whole lot of sense.

Where to start looking? One possibility is SOA-based dbMotion (part owned by the University of Pittsburgh Medical Center) which says it can pull of the neat trick of creating integrated patient records from data held by providers with no shared-data technology in place. Clinical workflow integration technology vendor Orion Health offers a portal-based, unified interface which can be layered on top of existing data. Its technology has already been in use for a RHIO integrating all providers in New Zealand for several years. Another entrant is Axolotl, whose "Virtual health Record" platform assembles chart-like on demand from all connect healthcare systems in a RHIO.

While you're at it, you may also want to check out the HiMSS Interoperability Showcase, which offers a living demonstration of a health information exchange using the Integrating the Healthcare Enterprise process and framework. It never hurts to see the real deal in action.

Case study: UPenn integrates patient data

Mon, 07 Jan 2008 06:59:54 -0500

After about a year of effort, the University of Pittsburgh Medical Center's network of hospitals and clinics will soon have access to a single, integrated view of key patient data. The project began, in essence, in October 2006, when UPMC inked a $35 million co-development deal and equity investment with SOA-based middleware and software tool maker dbMotion.

With the newly integrated architecture, doctors, nurses and other clinicians will be able to look at important data such as medications, drug allergies, lab results and immunizations all at once, despite the fact that the data came from multiple clinical systems including Cerner and Epic EMR technology. To roll out the new integrated view, UPMC will involve 45 providers at two ED sites, two ambulatory care practices and a 10-physician UPMC medical sub-specialty clinic. Eventually, it will be rolled out across the system's 20 hospitals and 400 outpatient sites, along with other doctors' offices and care facilities.

As useful as it is to integrate this data, will UPMC will be to share this data across a RHIO at some point (as policymakers would clearly like to see happen)? If this integration was that tough, imagine doing it all over again amongst multiple providers. It's something to think about.

To find out more about the case:
- read this Information Week piece

Related Articles:
Case study: UPMC partners for integration. Report
Case study: U of Pittsburgh develops with vendors. Report

Study: RHIOs aren't doing so well

Mon, 17 Dec 2007 06:59:58 -0500

Even if you're a big RHIO fan, these results must be a bit daunting. According to a new survey, almost one in four of 145 RHIOs dating back to last year have closed. Meanwhile, only 20 of the programs have actually gotten to the point of sharing health data, according to the study, which was published last week in the journal Health Affairs. The study, which was conducted by Harvard researchers, found that only 5 percent of RHIOs had posted a profit, while 40 percent rely on grants. Not only that, researchers concluded that RHIOs will need even more funding if they're to stay viable.

To find out more about the survey:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
Report questions RHIO business model. Report
Study: RHIOs grow slowly, rely on grants. Report
Study: RHIOs/HIEs back by states will win. Report
Long-lived CA RHIO shuts down. Report
A solution for RHIO privacy issues: EHR/EMR "banking." Editorial
Philly RHIO users visit competing providers. Report

ALSO NOTED: Automaker e-prescribing program a success; Military hires health IT security vendor; and much more...

Mon, 05 Nov 2007 06:59:50 -0500

> A group of automakers has seen some significant success from a new effort pushing e-prescribing for physicians treating its employees. Article

> The U.S. military has signed a $64 million contract with CACI International, under which the company will provide IT security to some of its healthcare programs. Article

> A Tampa Bay, FL-area group has gotten $3 million to roll out a RHIO. Article

> Consumers displaced by the recent California wildfires got a taste of how networked healthcare data can help displaced people maintain continuity of care. Article

And Finally… Ready to roll out an EMR? Don't do it until you tighten up your physician workflow processes, says one CIO. Article

National health networking: It takes a government

Mon, 08 Oct 2007 06:59:59 -0400

Last week, the federal government handed out $22.5 million in contracts to nine health information exchanges, whose job will now be to run trial implementations of the National Health Information Network. Another dull government program announcement? Not necessarily. We may be looking at something small here, as national projects go, but it's the start of something big.

As readers know, I'm not a huge fan of most current HIE/RHIO efforts, largely because I don't see them as sustainable. But as a little network known as "the Internet" reminds us, the government can slowly, stubbornly breathe life into networking projects that didn't have a leg to stand on before. So the fact that the NHIN has creeping along for years now doesn't mean the project is doomed by any means.

Ok, I admit that compared with the legal, strategic and financial issues involved in robust clinical data sharing efforts, building out the Internet was a carefree exercise. Nobody needed to be worried about sharing high volumes of mission-critical data with competitors every day, consumers weren't facing exposure of their most personal conditions to the broader world, and you didn't have to invest in a $500K+ enterprise system to get involved.

Not only that, while the development of IP networking standards wasn't trivial, the complexities involved in encoding and sharing clinical data put them to shame. Look at the Tower-of-Babel-like number of standards-development efforts out there. I don't have to implement them and it gives me a headache to contemplate it.

Still, if any entity can make national health data sharing a reality, it's the feds. Just imagine the grip of death the IRS puts on an errant taxpayer--then envision what can happen when similar levels of tenacity, thoroughness and institutional resources are turned towards the clinical data sharing problem.

Sure, it's still a long (maybe very long) term project, and there's probably obstacles ahead that will daunt even a massive agency like HHS. But even if you're buried in day to day enterprise IT problems, I would keep an eye on this project. That way, when you're called on to get involved, you'll know what to do.-Anne

Ohio works to foster HIE development

Mon, 01 Oct 2007 06:59:57 -0400

It looks like Ohio Gov. Ted Strickland (D) hopes to play catch up. When it comes to health IT, Ohio is lagging a bit behind other states, some of which are vigorously promoting health IT initiatives like e-prescribing and health information exchanges. Now, Gov. Strickland has issued an order creating an advisory board to coordinate public and private efforts aimed at building its own statewide HIE.

The new Ohio Health Information Partnership Advisory Board is chaired by the state's CIO. It's tasked with developing a plan for pulling together the HIE. It should help to pull together some relatively advanced efforts, such as the Cincinnati HealthBridge RHIO, but will extend their efforts. The group has just over 12 months to develop the plans.

To learn more about the state's plans:
- read this Government HealthIT piece

Related Articles:
Ohio health system rolls out e-prescribing. Report
Kentucky moves ahead with HIE plans. Report
Minnesota backs statewide HIE. Report