Regional Health Information Organization - Background/Motivations

Background/Motivations

The US system of Healthcare is highly complex and fragmented, with use of multiple information technology systems and vendors incorporating different standards. In contrast with other developed nations, healthcare accounts for a disproportionate percentage of the US GDP, and there is a concern about the economic viability of Medicare. Despite this significant expenditure, there is evidence of inefficiency, waste and medical errors, with a 2001 estimate by the Institute of Medicine of between 44,000-98,000 annual deaths due to medical errors. While numerous possible causes for this situation exist, much waste (e.g., duplication of laboratory tests) and medical errors (e.g., adverse drug reactions) are traceable to inability of healthcare providers (who are not the patients' primary providers) to access patients' existing medical information in a timely manner when needed: better and more ubiquitous health information technology might be part of the overall solution.

In 2004 President George Bush issued an executive order for the development and nationwide implementation of an interoperable health information technology infrastructure to improve the quality and efficiency of health care with the goal that most Americans will have an EHR by 2014. In July 2004 the United States Department of Health and Human Services released their vision of how America’s healthcare system could be rebuilt during the next decade. An aspect of the federal effort is the creation of the Office of the National Coordinator for Health Information Technology. One of the roles of ONC is to facilitate RHIO development.

The planning stage of RHIO formation involves 1) identification of a shared vision/motivation,2) creating a governance structure 3) identifying a technology and network infrastructure for data integration, 4) defining standards for data sharing, protection of data, and business practices to ensure patient protection during data exchange 5) defining educational and business strategies to ensure sustainability of the effort. Finally, RHIOs must implement the proposed strategies.