Dreams of Fanciful Things: Looking at HIE, RHIOs

It Doesn’t Make Sense

When we formed Health Monitoring Systems in 2006, Regional Health Information Organizations (RHIOs) were a big deal.  As a young company, we plotted an aggressive course and developed an internal White Paper on the topic.

For two months we researched, emailed and made calls — that was a significant investment for fresh, barely hatched company.  The result of our white paper was clear.

RHIOs didn’t make sense.  CHINs/HINs didn’t make sense.  Even dressed-up tricked out, new-fangled language HIEs don’t make sense.  They would just never become self-sustaining organizations.  They couldn’t.

The benefit from the exchange of data was always tomorrow.  Always over the river through the woods and 1/2 of the way to grandma’s house.

Since that time, we have done a lot of work exchanging healthdata.  EpiCenter collects data from over 400 hospitals and submits it to public health for analysis.  That’s health information being exchanged right there. MediCenter builds on that, reverses the data flow and provides medication history in an acute care setting.

So why does EpiCenter work?

EpiCenter is a purpose-driven example of health information being exchanged.  Between previous experience and work here at Health Monitoring Systems, our staff has worked with about 600 hospitals, pushing and pulling syndromic data getting better and better results.

More importantly, it works because public health receives benefit and public health is willing to pay.

And that is the key point — it works because someone who is willing to pay receives a specific benefit and takes a real interest in it.

The current model being advanced for health information exchange doesn’t do that.  So, it is hard for me to believe that it is somehow going to work.

What would work?

That is a big question.  It might even be a loaded one.  To answer it we need to peel back a couple of layers and determine what information needs to be shared and who benefits from the sharing.

Take the two together and if the benefit outweighs the cost, then you have a formula that works.

I’ll put some thoughts together in another entry here.  Until then email me (editor@hmsinc.com) or add your comment with your thoughts on what will make HIE work.