Healthcare IT News - January 2008 - (Page 41) www.HealthcareITNews.com management solutions a new appRoaCH The politics behind RHIO formation “can cause you to beat your head against a brick wall,” which is why Mark Renfro is taking a different tack in formulating the Northeast Florida Regional Health Organization. As executive director of NEFRHO in Jacksonville for the past two years, Renfro said he has veered away from the conventional RHIO diagram that has stifled so many projects to date. “NEFRHO’s mission is to improve quality and reduce cost and if you have hospitals heavily driving that mechanism it is counterproductive,” he said. “We started with a group of physicians and as we went forward we got payers involved, put a business plan together and got a grant from the state of Florida. High-profile specialists and primary care practitioners have been greatly involved and that is of major importance. We’re also getting employers involved and that is another stepping stone.” NEFRHO’s grant stipulates July 2008 as the deadline for a January 2008 ■ Healthcare IT News 41 working prototype of its information exchange to be completed. Scottsdale, Ariz.-based Carefx is building the clinical pipeline for NEFRHO, one of four major RHIO projects it has going right now. “This is a pilot deployment, intended to be a ‘production proof of concept’ – an example for a fully federated data extraction model,” said Oscar Diaz, executive vice president and chief software architect for Carefx. “The intent is to show how the technology will work throughout the state of Florida.” From a technical standpoint, the key to NEFRHO’s progress and eventual success, Diaz said, is data ownership and maintenance. “This model does not require the data to be moved – that in and of itself allows people to be comfortable with how the data is accessed,” he said. “The other key point is that data integrity is maintained by the source facility and not a third party. Basically, whoever generates the data, owns the data.” ■ More at healthcareITnews.com e connect: rHio 0108 rhIo Continued from page 40 Ho s p i t a l - p h y s i c i a n r e l a tionships are also taking on a more dynamic posture as information exchanges become more interactive, he said. “Instead of hospitals allowing doctors to merely view the information, they are giving them access to the hospital’s EMR system so doctors can take the next step and post it into their EMR,” Levin said. “They have a complete picture.” ● sTudy Continued from page 40 exchanged clinical data across a range of patient populations. “These findings suggest that nationwide electronic clinical data exchange will be much harder than what many people have envisioned,” said Julia Adler-Milstein, a doctoral candidate in health policy at Harvard University and the study’s lead author. “The expectation has been that we will have RHIOs throughout the country that bring together all the providers in their region and engage in comprehensive data exchange. In reality, we’re seeing few established RHIOs and those that are established only have a small number of participating groups exchanging a narrow set of data.” Adler-Milstein said that most successful RHIOs started by focusing their efforts on exchanging test results from laboratories and imaging centers. She believes that is where the clearest return on investment lies. Exchange of other data - such as clinical notes - is much more difficult to achieve, she said, partly because cost savings from such initiatives are less tangible. Establishing a successful RHIO is expensive, with significant upfront costs, Adler-Milstein said. The current approach to establishing RHIOs tends to rely on small start-up grants with the hope that participants will be willing to pay the RHIO once data exchange is initiated. The survey findings suggest that some RHIOs are struggling with the transition to self-sufficiency as eight of the 20 moderate-size RHIOs reported that they continued to depend heavily on grants. In contrast, nine never received grant funding. Thirteen RHIOs said they collected recurring subscription or transaction-based fees from participants to stay in operation. “If we want RHIOs to attain the vision of comprehensive health information exchange, we need to increase our investments in them,” Adler-Milstein said. “Otherwise, many of these RHIOs will be unable to sustain themselves under the current market-oriented approach.” ■ More at healthcareITnews.com e connect: Study 0108 driving collaboration and change throughout healthcare Visit Covisint at: HIMSS 2008, Booth 1231 Register to win a Grand Prix Specialty for Two to the Bob Bondurant School of High Performance Driving ● e ● connect: coViSiNt 0108 http://www.HealthcareITNews.com http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8444 http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8445 http://www.healthcareitnews.com/eConnect.cms?id=8481
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