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Are RHIOs Really Here?

April 17, 2007
by Mark Hagland
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What's new in RHIO-land, and how that plays into HIEs.

This year, regional health information organizations (RHIOs) continued to be one of the most-discussed topics at the conference, from regular educational sessions to the Sunday RHIOs Symposium, to lively exhibit floor conversations. But where were the operational RHIOs themselves?

Most evident this year, as last, was the boatload of challenges and hurdles — financial, operational, governance, technical, and political — that RHIO developers continue to face. Indeed, numerous presenters and speakers were heard using the broader term health information exchange (HIE) more often than the term RHIO, as RHIO efforts struggle forward.

Presenters acknowledged that the path ahead will be challenging. Indeed, Joe Carr, CIO of the New Jersey Hospital Association, said his organization has not yet committed to launching a statewide RHIO.

"In May, our board will decide whether or not NJHA should get involved in it," he said.

Meanwhile, things are moving forward in California on what would be the biggest statewide RHIO proposed to date — the California Regional Health Information Organization, or CalRHIO, which is expected to go forward this year, and act as an umbrella organization stitching together the 15 local and regional RHIOs in that state.

"We've spent $3.5 million bringing stakeholders together, analyzing costs and benefits, developing business models, establishing financing mechanisms, securing commitment," said Donald Holmquest, M.D., CalRHIO's CEO. "We hope to have a good, first, simple pilot live by the end of the year, and a good network on medication history and lab results" within two to three. Within seven, he hopes to have 70-90 percent of California residents covered.

Though confusion and delays continue in RHIO-land, some industry experts believe the fog will clear sooner rather than later. Wes Rishel, a managing vice president at Gartner, said that a small number of operational models are now emerging.

Mark Hagland is a contributing writer based in Chicago.