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Even with rapid-fire technology and the support of all involved parties, enhancing health care quality and bringing down costs are not quick or simple tasks. New efforts in electronic data sharing hold great potential, but they also carry significant risks without careful consideration and planning on the front end. To reach success, technology-based initiatives need financial support and more. It is imperative that they take a realistic look at the return on investment, develop a solid business case, establish an incentive for organizations to make the up-front investments needed, and plot out a plan for long-term financial viability. To begin this process, Regional Health Information Organizations (RHIO) are popping up throughout Ohio and across the nation. A RHIO can be any organized electronic sharing of health information. Toward the goals of better quality and lower costs, RHIOs work to improve the flow of clinical, financial and/or administrative data within the health care community as well as between hospitals and other organizations such as insurance companies, pharmacies, physician offices and laboratories. There are currently several organizations in Ohio that claim the RHIO label. These organizations are in various stages of implementation, and each deals with specific issues in their local community: Healthbridge – Serving the Greater Cincinnati area, Healthbridge includes 18 hospitals and represents nearly 90 percent of the community hospital sector activity. It also connects many physicians as well as nursing homes, independent labs, radiology centers and others in the health care communities. It is focused on building electronic data exchange, including things such as radiology images and laboratory results. (www.healthbridge.org) NeoRHIO – This RHIO, based in the Cleveland area, is just getting started and establishing its goals for Northeast Ohio. Healthlink Miami Valley RHIO – Housed at Wright Sate University’s Center for Healthy Communities in Dayton, this RHIO works closely with the electronic exchange of children’s immunization records, sharing the information with schools and other organizations. (www.med.wright.edu/healthlink/) Appalachian Regional Informatics Consortium – Affiliated with Ohio University’s College of Osteopathic Medicine in Athens, this group received a grant from the National Institutes of Health in 2004 to plan for a comprehensive community-based health information system. ARIC created a model for developing a rural RHIO in Appalachia Ohio to allow health care providers to exchange patient health information. (www.oucom.ohiou.edu/aric/) CompeteColumbus Health Innovation Cluster – This group will tackle the development of a Central Ohio RHIO to help move patient and other information across information systems and facility borders. (www.columbus.org/region/development/medicine.aspx) Currently, no Ohio RHIO has a statewide focus, but groups like the Health Policy Institute of Ohio (HPIO) are bringing stakeholders together and studying the creation of a statewide framework. HPIO’s conversations with the state’s RHIOs, health care organizations such as OHA, the Ohio State Medical Association and the Ohio Osteopathic Association, government, insurers and businesses are a healthy start in this fairly uncharted territory. The Utah Health Information Network (UHIN) is the only unified statewide RHIO in the U.S., and it has successfully exchanged administrative health data in its state for 12 years. As the number of RHIOs in Ohio continues to rise and the degree of information exchanged increases, some level of collaboration and communication across these various entities also will be critical to promoting more efficient, cost-effective, and better quality of care. Given the local nature of Ohio’s RHIOs and the potential for duplication, the responsibility of promoting and ensuring coordination across RHIOs is likely to fall to state and federal government. Government and other stakeholders will be asked to play a number of roles: conveners, facilitators, funders, data sources and project partners. Individual hospitals, the greater hospital community and OHA will work with legislators, HPIO, RHIOs and others over the next biennium to realistically explore how health information exchange can give Ohioans better health care at better prices.
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