Why did RHIOs fail?
RHIOs have failed in the US because all the stakeholders want to hold on to their data. US Healthcare is a privately funded healthcare system where every stakeholder has to protect their business interest. Without any single controlling agency its impossible to bring all stakeholders to share their data.
Whereas in commonwealth countries its a Govt funded, Govt controlled Healthcare system e.g. Canada, UK, Australia, India. Sharing of data is possible because all data belongs directly or indirectly to the Govt. If there is a reliable system to protect and share data then all stakeholders will share data. Therefore the huge investments integrated electronic health record systems (iEHRS) are in the right direction and will surely be a success.
We will soon see next wave of innovation from the countries where healthcare data becomes sharable. Especially closing the loop where data is available for Evidence-Based-Medicine and Epidemiology.
posted by robusthealth at
10:06 AM
3 Comments:
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By
dentist, At
June 16, 2008 at 3:25 PM
Many RHIOs have failed - yes - but not all. A small number provide simple results delivery and messaging services and are financially sustainable for many years (e.g., HealthBridge). If the purpose, though, is to have all of the patient info at the point of care, then yes - we don't see that from RHIOs, yet. But I work closely with those doing work in the UK and Canada (as well as the US), and frankly, they still are not able to provide this. Innovation as you describe will happen where there are any large amounts of continuity of care information - we currently see in organizations such as Kaiser, and may see it becoming available to those that opt in to future services through MS HealthVault, GoogleHealth, etc. It appears that it will happen in countries as you describe that control the data, or in other more private-property/free market-oriented countries when consumers opt in, control the data in consumer-directed repositories (if multi-institutional) or within institutions. The Internet is one example of how consumers are using IT to take more control of their lives, and recent surveys (www.markle.org) show this is going to occur with consumer health data. You may be interested in what is happening with the health record bank concept in states such as Washington. Governments are not more intelligent, and cannot be more intelligent, than the people that support them. Thus, if there is value, and it is properly communicated to people in the marketplace, then they can vote (sometimes with their dollars or opting-in) to participate in a system that will allow their healthcare quality to increase through IT.
By
Unknown, At
June 29, 2008 at 6:15 AM
A lot will also depend on the EMR(electronic medical record) applications and different vendors providing such application.
The foundation of anything like National Health Information Network(NIHIN), RHIOs or even Google Health or MS Health Vault is the EHR(electronic health record), which is a subset of each care delivery organization's EMR. An effective EHR can be evolved only if EMR of various organizations evolve to a level that can create and support a robust exchange of clinician data across any boundary.
In this respect specifications like ASTM's Continuity of Care Record(CCR) or HL7's Continuity of Care Document(CCD) will play an important role.
EMRs will never achieve it full potential or its true goal without interoperable EHRs in place.
So once we have such effective EMRs from various vendors, which will allow seamless flow of clinical data, its going to be lot more easier to implement RHIOSs or NHINs or PHINs(Person Health Information Network)
By
Nikhil, At
July 4, 2008 at 12:45 PM
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