What does it take to successfully build a regional health information organization?
It takes flexibility, with privacy and sustainability as key issues near the top of the list, two top RHIO innovators told attendees of the 16th Annual Partnering for Electronic Delivery of Information in Healthcare (WEDI) national conference in Baltimore.
Minnesota RHIO
Mike Ubl, director of eHealth and IT Strategy for Blue Cross Blue Shield of Minnesota and the WEDI board chair-elect said efforts since 2004 to establish a RHIO in Minnesota "have never been about the money."
Ubl said he is glad to see a greater emphasis in Minnesota on quality of care and patient safety rather than on trying to make "a big financial killing."
"The whole premise is that we will be making more appropriate decisions at the point of care that will result in lower costs," said Ubl.
The Minnesota RHIO began its efforts by focusing on e-prescribing with the overall goal to save lives and improve healthcare, he said.
Ubl said planners of the RHIO have faced challenges in trying to set up a seamless process for transmitting and storing prescription drug information. "All we are looking for are basic functions that aggregate data, but it's not that simple in a complex environment with a lot of stakeholders," he said.
"The key here, is always be flexible," Ubl advised.
The Minnesota-based RHIO is looking into funding from the state as a form of sustainability and still has to look hard at some patient privacy issues, he added.
CalRHIO
Don Holmquist, MD, president and CEO of CalRHIO, said founders of the CalRHIO effort have a vision that the RHIO will serve a function, much like a utility company.
We decided we need to be a "utility" that delivers the information when requested, Holmquist said.
"We need to provide what no one else wants to do," Holmquist said. "If we make every small community, whether for one city or for an entire state, raise money for a RHIO it could take forever."
Planners of the RHIO have been meeting for a year and in seven years they would like for all California residents to have electronic health records, Holmquist said.
"One reason we need a state-level HIE is there aren't going to be RHIOs everywhere," Holmquist said. "If we don't go in and help them, it's just not going to happen."
CalRHIO planners hope to set up shop in local communities first, such as Sacramento. "It makes a lot of sense to help local efforts and then connect them," Holmquist said.
Planners of CalRHIO said they anticipate needing $300 million in seed money, and they expect to get it up front from vendors who contract for the project. CalRHIO should be up and running within a year, Holmquist said.
"We've got to be adaptable and flexible," Holmquist said of the entire planning process.
Rising costs and poor quality of healthcare in America "is everybody's fault and it's our responsibility to fix it," Holmquist said. "I feel some urgency. Whatever it costs, we have to do it."
"If you're in this business, you're in the right place," he added.