Healthcare IT News - January 2008 - (Page 40) 40 Healthcare IT News January 2008 ■ management solutions www.HealthcareITNews.com orations using the same rules and principles EALTHCARE PROVIDERS ARE of information sharing, funding and techniMORE INVOLVED in health infor- cal methods to facilitate the exchange,” she mation exchanges than ever before, said. “The data resides at multiple levels of though they don’t necessarily conform to the the systems – national data sets, regional data RHIO geographical format, the results of a sets and local data sets. I don’t believe there is a ‘one size fits all’ approach today. Much of new survey show. Based on responses to its fourth annual the data only resides locally in labs, pharmasurvey, eHealth Initative concludes that cies and physician offices. A national system health information exchanges are continu- doesn’t solve that – national standards do.” One of the most pertinent findings in the ing to advance and evolve toward their respective goals, with at least 125 commu- eHI survey relates to the challenge in developing a sustainable nities supporting business model some semblance “they’re not all – 56 percent of of a health data RHios. they’re respondents classinetwork. While just collaborations fied it as “very difthe “heavy lifting” ficult” and another phase of impleusing the same 35 percent called it mentation has rules and principles “moderately diffislowed progress of inFoRmation cult.” Marchibroda considerably for blames the current many projects, sHaRing, FunDing anD reimbursement systhey are continuing teCHniCal metHoDs to tem, which she says to plod forward, facilitate the exchange.” rewards volume the Washington– Janet Marchibroda and fragmentation. based non-profit “The way we pay group reports. “Increasingly such efforts are involving for healthcare is to reward those things and all stakeholders within the system, includ- discourage providers from sharing informaing clinicians, community health centers, tion,” she said. “As a result, communities consumers, employers, health plans, hospi- that get their providers to share are pushing tals, laboratories, pharmacies, public health uphill.” Solvang, Calif.-based MedSeek works closely agencies and government,” eHI officials said in a survey summary. “Twenty of the 130 with provider organizations to facilitate RHIOs initiatives included in the 2007 survey are and senior vice president David Levin agrees just getting started, 68 are in the process of that they are taking on different facades. “We are seeing a change in the scope of the implementation, 32 are operational, five are no longer moving forward and five did not RHIO – individual hospitals are taking leadrespond to the survey question regarding ership roles in connecting physicians to their network. While hospitals still struggle with stage of development.” CEO Janet Marchibroda says her group the value proposition of an exchange, the situdoes not use the term RHIO because there is ations where there is a hospital and physician no standard definition and that many health have become more active. This isn’t a textbook data exchanges don’t confine themselves example of a RHIO, but the concept is consistent,” he said. geographically. “They’re not all RHIOs. They’re just collabrhIo see page 41 By John Andrews, Contributing Editor RHIOs struggle to evolve, create a new identity H Harvard You Covered. serious doubt We’ve Gotstudy castsdata exchanges on future You We’ve Got of healthCovered. By rIchArd PIzzI, Associate Editor BETHESDA, MD – Wishard Health Services in Indianapolis is part of a Regional Health Information Network formed two years ago by the Indianapolis Network for Patient Care, in conjunction with Initiate Systems, the Regenstrief Institute and RxHub. Based on responses to its fourth annual survey, eHealth Initiative concludes there are at least 125 communities in the United States involved in some sort of health data network. Electronic clinical data exchange across the United States is far from a reality, with few organizations facilitating such exchange and many failing in the process, reports a new study by Harvard researchers published last month on the Health Affairs Web site. The study, based on a 2007 survey of 145 regional health information organizations (RHIOs), is an assessment of the state of electronic health data exchange in the United States. Electronic health data exchange between hospitals, doctors’ offices, labs, and other clinical settings has been hailed by many in the healthcare industry as the key to improving the quality, efficiency and coordination of care. But the new survey, funded by Harvard’s Program for Health Systems Improvement, identifies serious barriers to achieving this goal with the current approach. The authors note that at the time the survey was conducted, nearly one-quarter of the 145 RHIOs were defunct, and only 20 initiatives were deemed to be of at least modest size and exchanging some clinical data. Five of those RHIOs exchanged data for a specific population, such as Medicaid enrollees, the uninsured, or patients with a chronic illness like diabetes. 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