Top health IT leader urges standards for RHIOs

With the growth of the grass-roots organizations beginning to share patient data regionally, the George Bush administration's point man for health IT wants to establish standards and guidelines for how these groups are governed and financed.

In his keynote address at the Healthcare Information and Management Systems Society's annual conference in San Diego, David Brailer said his office this year will be focusing its efforts on forming guidelines and minimum standards to help regional health information organizations (RHIO) form and grow.

Brailer, the national coordinator for health information technology, said his office will be detailing a new contract within a month designed to take stock of existing RHIO efforts with an eye toward mapping out how these evolving groups will fit into the government's plan to help foster a national infrastructure to support the widespread adoption of electronic health records (EHR).

"I did not start out by believing the national solution will be a network of regional networks," he said. "Our goal with the national health information network is to allow those who do not want to [participate in RHIOs] do not have to do it. We want RHIOs to know where we are heading so they can make their plans accordingly."

Brailer's Office of the National Coordinator for Health Information Technology (ONC) in November awarded four contracts to a consortium of IT vendors to develop a prototype for a National Health Information Network to securely exchange patient data among hospitals, laboratories, pharmacies and physicians.

Brailer said he envisions the network evolving to provide a set of tools and services that doctors and hospitals could use to exchange data nationally or as a network that RHIOs could tie into themselves. The new effort will help ensure that in states where there is more than one RHIO, that an overarching statewide entity will be formed to help local groups deal with governance, financial and operational challenges.

"If we have RHIOs governing themselves locally, there needs to be something that ties them together," he said.

The ONC does not now have plans to regulate the RHIOs, Brailer said. But he noted that if his office fails to move the market toward the President Bush's goal of every American having an EHR by 2014, regulations could come into play.

"If it turns out we can't get traction ... there is a group of people who will bring mandates forward," he said. "We are beyond the point where this is optional. The clock is ticking."

Brailer also described ONC plans to seek US$116 million in fiscal 2007, almost twice its 2006 budget of $61 million.

According to ONC, there are about 66 RHIOs in the U.S. that are either in the planning stages or have begun to share patient data electronically. In addition, 30 states have introduced or passed legislation that supports the statewide adoption of health-related IT.

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