In reading about Regional Health Information Organizations (RHIO), it is interesting to note how colossal and incredibly complex some possible solutions seem. Health information exchange (HIE) is the goal of these organizations along with facilitating improvements in healthcare. Unfortunately, many of the proposals being ping-ponged about today lose track of this goal due to financing, collaboration, and planning issues. Currently, this movement and the technology are still largely in the visualization and troubleshooting phase. There never has been a one-size fits all solution that could cure the health care system, and yet that is how many innovations including Electronic Medical Records, Computerized Physician Order Entry (CPOE), and RHIOs are presented. It is important that development and application do not interfere with the health care process. As a distant goal, HIE is an excellent idea that has the potential to facilitate a lot of positive developments, but perhaps on a smaller scale. As a more immediate endeavor, it is presenting with mixed results and stumbling on issues like implementation, usability, and lack of collaboration.
While each individual HIE endeavor and its successes and failures are unique, collaboration is an element that should be included in business plans more and more. Many health care professionals continue to maintain that patients, consumers, physicians, IT professionals, and accountants should all be a part of discussion, development, and usage of RHIO and HIE. In his article, “Health Improvement Technology,” Dennis Schmuland, M.D., writes, “The fixation of the industry and health information technology community on digitizing and exchanging health data and information has caused the industry to undervalue the breakthrough possibilities of collaboration technologies.” Technology provides a means to achieve, but health information exchange cannot occur without participation from all parties involved. Here in Milwaukee County, a major part of the Emergency Department Linking Project was an agreement and collaboration between the “CEOs of all the major health systems in the Milwaukee metropolitan area to commit to the project” (Hagland 1).
Per the ED Linking Project Information Paper, “The primary goal of the ED Linking project is to provide patient health information where currently there often is none or very little available to help ED and Community Health Center clinicians in Milwaukee County provide patients quality, safe, and cost-effective health care” (Webb 1). Initially, the project focused on sharing information on patients and visits to the emergency department. Laboratory results, medication data, and insurance information will eventually be exchanged as well, if they are not already a part of this project. Perhaps what hurts health information development most is extremely aggressive deadlines which make agreeable growth and collaboration between vendors, IT professionals, doctors, health care providers, and patients. The incremental approach Milwaukee’s ED Linking project has taken allows for adjustment, adaptation, and room for growth. According to Dr. Mark Friesse, Professor of Biomedical Informatics at Vanderbilt, “Every state is doing great things. Everyone is teaching us a different part of the answer” (Blair 6). In some ways, this may broaden perspectives and help piece together a model RHIO or HIE to build off. Undoubtedly, some will chalk this up to progress being made, but real progress might more clearly be made via collaboration and real health information exchange.
Unfortunately, there is no shortage of obstacles to tackle and issues to understand surrounding RHIO and HIE foundation. If everyone was equally motivated, eager to learn, and up to date with the state of health care, modernization might be much to easier achieve. Kind of like a science fair, this phase will undoubtedly have more successes and flops. Establishing more meetings to initiate these exchanges is a good way to enable health information exchanges. There are groups that focus solely on idea sharing, learning experiences, and problem solving dialogue for these reasons. Listed below are some examples:
- North Carolina Healthcare Information and Communications Alliance Inc. http://www.nchica.org/
- HIE Seamless Exchange Solutions http://www.hielix.com/
What do you think? Should there be more collaboration among RHIO development? Please, do hesitate to chime in and share your thoughts.
About The Author:
Mario Raspanti is a Staff Writer with the Clear Medical Solutions Communication Team. His work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.
Blair, Robin. “RHIO Nation.” Health Management Technology: The Source for Information Systems Solutions. February 2006. http://www.providersedge.com/ehdocs/ehr_articles/RHIO_Nation.pdf
Hagland, Mark. “From Struggles to Success: Part technology, part cooperation and part good old fashioned trial and error are what it takes to build or break a RHIO.” Healthcare Informatics. http://www.healthcare-informatics.com/ME2/Sites/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=AE404FB40DFE434B91B79D9C2AD6BF50&SiteID=Main%20Si_e
Schmuland, Dennis. “Health Improvement Technology.” Health Management Technology: The Source for Information Systems Solutions. May 2009. http://www.healthmgttech.com/features/2009_may/0509_health.aspx
Webb, Denise. “Emergency Department Linking Project Information Paper.” <http://ehealthboard.dhfs.wisconsin.gov/materials/materials/EDLinkingProjectInformationPaper06102008update.pdf>