Two studies report RHIOs are struggling

December 28, 2007

Regional health information organizations, are supposed to be the building blocks of a national system for sharing electronic patient data. But 36 of these groups are already defunct.

Regional health information organizations, or RHIOs, are supposed to be the building blocks of a national system for sharing electronic patient data. But 36 of these groups are already defunct.

RHIOs consist of physician practices, hospitals, insurers, and other healthcare players that connect their computer systems to exchange lab results, chart notes, hospital discharge summaries, and the like. However, RHIOs have struggled to become financially self-sustaining, according to a study in the November/December issue of Health Affairs.

The study examined 138 RHIOs that existed as of July 2006 (the original count was 145, but seven organizations didn't meet the definition of a RHIO, it turned out). One out of four had seemingly disappeared from the face of the earth by early 2007, despite the efforts of researchers to verify their existence and make contact. It wasn't clear, the study stated, whether other RHIOs would avoid the same fate. One-time grants, it noted, have jump-started many of these organizations, but this easy money can also tempt RHIOs to neglect getting the kind of buy-in from doctors, hospitals, insurers, and other parties that would lead to long-term success.

Another disheartening view of the RHIO landscape comes from the eHealth Initiative, a group that has nurtured attempts at regional data sharing. Only 32 of the 130 RHIOs surveyed by eHealth Initiative are fully operational, that is, exchanging data. Of these, three-quarters report that they no longer depend on grants from government, hospitals, and other sources, but derive ongoing revenue from membership, subscription, and data-transaction fees. Twenty operational RHIOs are said to possess a "sustainable business model." Nevertheless, 91 percent of all RHIOs say that achieving such a model is a difficult challenge. These findings appear in an annual report on RHIOs that the eHealth Initiative published last December.