A subtle but profound shift is occurring in the world of RHIOs/HIEs (Regional Health Information Organizations/Health Information Exchanges).
…and the title of the eHealth Initiative’s Sixth Annual Survey of Health Information Exchange says it all:
What’s happening here?
In the past, RHIOs have defined their raison d’etre (reason for being) fairly simply: exchanging health information among local health care stakeholders.
They are recognizing that the exchange of health information is necessary, but not sufficient for health system improvement and change.
This is the same cat/dog dialogue that was catalyzed by HITECH Act Legislation. Should the definition of “meaningful use” of certified EHR technology:
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Emphasize “use” – the simple adoption and use of technology (the cat POV)
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Emphasize “meaningful” — improvements in outcomes, quality improvements, and cost reductions that are enabled by implementation of multiple, modular technologies — not just EMR 1.0 (the dog POV)
Early direction from the HIT Policy Committee has been very clear and positive. Dr. David Blumenthal, National Coordinator for Health Information Technology, charted the course in this June interview with the Wall Street Journal:
WSJ: Critics contend that the system is tilted toward older technologies and won’t allow for much innovation.
Dr. Blumenthal: The last thing we want to do is inhibit innovation in this very young industry. There are contending priorities. There is a strong desire to get the technology to the physician and have it used in doctors’ offices. There’s also the concern that we’ll put the industry in a straightjacket (by endorsing only existing equipment).
We’ll try to resolve these issues by focusing on performance rather than any specific technology. We’ll say to the industry and providers of care: We don’t care how you accomplish critical tasks, so long as you do so with electronic technology.
If someone produces the equivalent of an Apple iPhone, where the doctor selects certain applications, that’s fine — so long as it works.
Dr. Blumenthal — thank you for the inspired leadership you are demonstrating!
RHIO’s/HIEs are recognizing they can and must contribute to “meaningful use”. Subtle, and profound.
More on the important topic later…for now simply wanted to flag this significant, shifting trend.
Article Series - The Dog Manifesto: A Disruptive Innovator's Guide to Health IT
- Will HITECH Lead to Innovation? The Continuing Cat/Dog Dialogue
- Dogged Optimism: Five Innovative Aspects of HITECH
- Feline Foot-Dragging: Three Non-Innovative Aspects of HITECH
- Wait and See: What’s Unclear or To-Be-Determined (TBD) About HITECH.
- Can Cats Think Outside the Box? Here’s a Role Model.
- Stand for Quality Group: “Link HIT Investment to Quality Improvement”
- EHR 2.0: Thinking Outside the Cat Box
- Stunning Announcement: AMA Goes to the Dogs in Deal With Physician Web Portal Company
- Markle v. HIMSS: Differing Views of “Meaningful Use” and “Certification”
- Time for EHRs to Become Plug-and-Play
- Blueprint for Change: From EMR 1.0 to Clinical Groupware (EHR 2.0)
- Joe the Doctor: “…’scuse me, why do I want to bet-my-practice on an EMR?”
- RHIOs Emerging From Coma
- HIT Policy Committee Recommends “Minimum” Certification of EHRs
- PR Blunder of the Year: Federation of American Hospitals Says Meaningful Use Should Not Tie to Quality Improvement
- The Third Rail in HITECH Implementation: “Please Don’t Make Us All Speak Latin”
- Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask
- John Halamka’s Stunning 180: “Dogs and Cats Should Live in Harmony”
- Feedback Rolls in on Halamka’s New Stance on Standards: Cats Pissed, Dogs Thrilled


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