A Regional Health Information Organization, or RHIO, is a consortium of organizations in a defined geographic area that wish to share health information to increase the efficiency of the community’s healthcare delivery system and thereby improve the health of individuals and of the community in general.
A RHIO may have a wide variety of member organizations: healthcare providers, hospital and health systems, insurance companies, health departments, and in some cases community employers. The benefits of participation for each member vary widely, but one overarching requirement for a successful RHIO is financial sustainability. This means that most basic benefits to the members of the RHIO are economic. Once sustainability has been achieved other benefits for members can be realized.
A RHIO is set up to develop a method of sharing information among its members. The methods developed by a RHIO for sharing information can take on several forms.
In general a RHIO will:
- Design the business structure of the RHIO
- Set membership requirements and recruit new members
- Develop a general system architecture to facilitate data exchange
- Provide technical support and implementation
- Secure financing to ensure sustainability for the program
- Manage legal and regulatory issues surrounding data exchange
In addition, a RHIO may serve as a central purchasing organization and provide members with discounts to technology and services required to participate in data exchange programs.
To provide data exchange among members, a RHIO may use either a federated architecture or a centralized architecture. A federated architecture supports data sharing through interfaces between various community systems. This model generally provides more control over what data each member wishes to share but can be more costly because a potentially large number of interfaces must be created and maintained. A centralized architecture is based on a Central Data Repository (CDR) that houses the information that the members are willing to share. Each member contributes information to the CDR and receives information back from the CDR.
In some cases these two system architectures are combined into a hybrid architecture. Members may share some types of information using direct interfaces, as in the federated architecture, but may also contribute to and obtain information from a CDR.
The key to developing a successful RHIO is community participation. Next month we will examine the benefits of participation to RHIO members.
