Study: Broader group of stakeholders improve likelihood of RHIO operationality
Finding ways to help regional health information organizations (RHIOs) become operational and self-sustaining will bolster the current approach to nationwide health IT, according to an article in the December edition of the Journal of the American Medical Informatics Association (JAMIA).
Julia Adler-Milstein, a doctoral candidate in health policy at Harvard School of Public Health in Cambridge, Mass., and colleagues conducted a survey of all known RHIOs in the U.S. in mid-2008 to identify factors associated with RHIO viability. RHIOs were defined as entities providing a technical infrastructure to support clinical data exchange between independent entities in a geographic region.
A Web-based survey asked the directors of RHIOs to report their organization’s demographics, level of progress in facilitating health information exchange (HIE) at two points (Jan. 1, 2007 and June 1, 2008), types of data exchanged and functionalities supported, funding sources and financial viability and barriers to development. Whether the RHIO was operational and the percent of operating costs by revenue from participants in data exchange were the main outcome measures examined.
Using a multivariate logistic regression model, identifying predictors were created including breadth of participants, volume of data exchanged, whether the RHIO focused on a specific population, whether RHIO participants had a history of collaborating and sources of revenue during the planning phase.
With an 83 percent response rate from 207 organizations, 81 responses were used in the report's analysis after the sample’s focus was narrowed. Forty-three of these RHIOs were operational (actively exchanging clinical data as of June 1, 2008), 27 were planning for clinical data exchange and the remaining 11 had pursued clinical data exchange in the past but were no longer pursuing it as of June 1, 2008, according to the researchers.
Adler-Milstein and colleagues also noted that RHIOs were fairly evenly spread across the country and usually had city/country-level coverage (69 percent) compared to a statewide focus (30 percent).
Exchanging a narrow set of data and involving a broad group of stakeholders were independently associated with a higher likelihood of being operational according to the report’s findings. Involving hospitals and ambulatory physicians, and securing early funding from participants were associated with a higher likelihood of financial viability, while early grant funding seemed to diminish the likelihood.
“Our work suggests that RHIOs find a broad group of stakeholders and begin with a narrow set of activities to help them get off the ground,” the study authors concluded. “Further, we believe that judicious use of grants, possibly through ‘matching’ mechanisms where stakeholders are also asked to contribute early, will help to ensure that RHIOs become viable and self-sustaining.”
Julia Adler-Milstein, a doctoral candidate in health policy at Harvard School of Public Health in Cambridge, Mass., and colleagues conducted a survey of all known RHIOs in the U.S. in mid-2008 to identify factors associated with RHIO viability. RHIOs were defined as entities providing a technical infrastructure to support clinical data exchange between independent entities in a geographic region.
A Web-based survey asked the directors of RHIOs to report their organization’s demographics, level of progress in facilitating health information exchange (HIE) at two points (Jan. 1, 2007 and June 1, 2008), types of data exchanged and functionalities supported, funding sources and financial viability and barriers to development. Whether the RHIO was operational and the percent of operating costs by revenue from participants in data exchange were the main outcome measures examined.
Using a multivariate logistic regression model, identifying predictors were created including breadth of participants, volume of data exchanged, whether the RHIO focused on a specific population, whether RHIO participants had a history of collaborating and sources of revenue during the planning phase.
With an 83 percent response rate from 207 organizations, 81 responses were used in the report's analysis after the sample’s focus was narrowed. Forty-three of these RHIOs were operational (actively exchanging clinical data as of June 1, 2008), 27 were planning for clinical data exchange and the remaining 11 had pursued clinical data exchange in the past but were no longer pursuing it as of June 1, 2008, according to the researchers.
Adler-Milstein and colleagues also noted that RHIOs were fairly evenly spread across the country and usually had city/country-level coverage (69 percent) compared to a statewide focus (30 percent).
Exchanging a narrow set of data and involving a broad group of stakeholders were independently associated with a higher likelihood of being operational according to the report’s findings. Involving hospitals and ambulatory physicians, and securing early funding from participants were associated with a higher likelihood of financial viability, while early grant funding seemed to diminish the likelihood.
“Our work suggests that RHIOs find a broad group of stakeholders and begin with a narrow set of activities to help them get off the ground,” the study authors concluded. “Further, we believe that judicious use of grants, possibly through ‘matching’ mechanisms where stakeholders are also asked to contribute early, will help to ensure that RHIOs become viable and self-sustaining.”