Healthcare integration is happening at the local levels, not all at the HIE or RHIO level
There used to be a saying that “all politics is local,” meaning that how to get elected or get things done was at the local level. This was the idea behind a post several months ago entitled All Healthcare Integration is Local. While there are many grand initiatives happening (from IHE to HIEs to RHIOs, etc.), the actual integration work is happening with several leading health care entities. The local approach is taking hold with hospitals and their efforts to connect to the referring physician community without a RHIO-type effort.
In a recent Health Data Management article entitled The Hospital as the Network Hub, the telling statement is: “The hotbed of networking activity in health care today involves hospitals linking with their referring physicians, not broader RHIOs or health information exchanges…”
The motivation for hospitals to implement their own networks is described as:
- Competitive pressures: Make it easy for community physicians to refer patients and access data.
- Enhance reputation: Focus on specialty physicians – cardiology or oncology – to dominate local market niches.
- Timing: Now is better than later… can’t afford to wait for community-wide HIE initiatives.
Hospitals are taking advantage of the Stark Law changes and are hosting applications (such as EMRs) for their referring physician community. In a hosted environment, providing the connectivity and electronic exchanges for patient data becomes a more manageable approach than larger scale HIE initiatives.
RHIOs and HIEs will still play a role in the longer term, larger picture approach. However, the local approach to healthcare integration is happening now (as it should), and it is working.
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