RHIOs fail to thrive, new study finds
By Nancy Feris
A new study finds that despite the widespread interest in regional health information exchanges in recent years, only 20 RHIOs in the United States are fully functional and a dozen are self-sustaining.
Calling RHIOs’ survival in their current form “tenuous at best,” the study questions many of the prevailing assumptions about how a nationwide health information network will emerge.
Policy-makers at the Health and Human Services Department and in the health information technology community expect RHIOS to serve as the building blocks of a national system. But many face an uncertain future, the studyâ€™s authors report.
The study, â€œThe State of Regional Health Information Organizations: Current Activities and Financing,â€? appeared today in an online edition of the journal Health Affairs.
The authors, led by Harvard University graduate student Julia Adler-Milstein, identified 145 RHIOs nationwide that were getting under way in recent years. Of them, â€œonly 20 were functioning at even a modest scale, and only 15 were doing so for a broad set of patientsâ€? as of Jan. 1, according to the article.
Nearly one-quarter of the RHIOs known to exist in mid-2006 were defunct by early 2007, it states. â€œOur results suggest that at most 12 of [the 20 functioning] RHIOs are self-sustaining, since eight continue to receive moderate or substantial grant funding,â€? it adds.
â€œThese findings suggest that nationwide electronic clinical data exchange will be much harder than what many people have envisioned,â€? Adler-Milstein said in a statement released by Health Affairs. â€œThe 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, weâ€™re seeing few established RHIOs and those that are established only have a small number of participating groups exchanging a narrow set of data.â€?
According to the article, â€œit is not clear whether even more mature RHIOs have a clear path to becoming financially sustainable.â€? Most of those RHIOs deliver results of laboratory and radiology tests to doctors, and the article says this is the where the return on investment is most achievable.
â€œIf we want RHIOs to attain the vision of comprehensive health information exchange, we need to increase our investments in them,â€? Adler-Milstein said. â€œOtherwise, many of these RHIOs will be unable to sustain themselves under the current market-oriented approach.â€?