Neither new nor innovative, collaborations and partnerships appeal most to optimists and idealists who can envision an environment that is mutually beneficial. Optimism drives such arrangements, as it's always easier to see the potential than to hammer out the details of responsibilities and deal with the day-to-day tasks.
Although partnerships between providers across the care-delivery continuum — usually through referral or care coverage — are common, other types of partnerships involving provider organizations are just beginning to evolve and mature. Driven by various strategies, these organizations are forming more formal partnerships and collaborations with other care-delivery institutions as well as with health plans and vendors.
The more standard beta-site partnerships, which enabled a price break to providers willing to "test drive" a vendor's new system and identify the bugs before general release, still exist. However, more providers, especially those with innovative ideas and some flexibility in IT staffing, are becoming intimately involved in development relationships tied to ongoing financial benefits. (See Making it Work, page 20)
As public-private collaboratives — such as the Washington, D.C.-based eHealth Initiative and New York-based Connecting for Health — strive for consensus among disparate groups, they are delivering guidelines to achieve common goals. Recognized for their foundation work, including funding for health information exchanges (HIEs), these groups have maintained their focus and have been very effective in conveying their vision for a connected healthcare delivery system.
Even government groups, which have had some past difficulties leveraging investments across departmental lines, have some wins, such as the Honolulu-based Pacific Telehealth & Technology Hui, a partnership between the U.S. Army's Pacific Regional Medical Command, Tripler Army Medical Center (TAMC) and the Veterans Affairs Medical and Regional Office Center (VA), Honolulu. Best known for its telehealth projects in the Pacific, the Hui's recent efforts focus on dissemination of the VA's VistA system.
Industry groups aren't new, but the focus on goals beyond self-promotion is growing. The National Alliance for Health Information Technology, for example, targets advancing the adoption of clinical information technology systems and is a co-founder of the Certification Commission for Health Information Technology. And recently, Armonk, N.Y.-based IBM teamed with the World Health Organization, the Centers for Disease Control and more than 20 other worldwide health agencies and academia in a Global Pandemic Initiative to curb the spread of infectious diseases.
Collaboration between health plans and providers has certainly improved, particularly in the area of disease management, but much is lacking. Data sharing partnerships between the two would marry health plans' large, but fairly shallow information with providers' smaller, but in-depth information to benefit each other and patients.
Lexington, Mass.-based Erica Drazen, ScD, vice president, First Consulting Group, is proud of her state, calling it a microcosm where collaborations flourish. It has the New England Health Exchange Network, a collaborative claims processing network, and now a statewide initiative to drive healthcare IT adoption, notably through its goal to have computer-based physician/provider order entry in all hospitals within the state. She credits the local nature of healthcare (no dominant national health plans) with the success of collaborations forged on a more personal level.
In the end, all collaborations are personal in nature. And if regional health information organizations and HIEs are going to succeed, all stakeholders will need to be involved and work together at the personal, as well as organizational, levels. It's not too soon to start thinking about building consensus and getting every member onboard.