"It's always amazed me that some organizations that are part of RHIOs are not yet effectively exchanging information among their own facilities. It's like putting the cart before the horse," says Deborah Kohn, principal at Dak Systems Consulting, San Mateo, Calif.
For broader, collaborative networks to succeed, Kohn argues, the participants must first have their own networks in place.
The hotbed of networking activity in health care today involves hospitals linking with their referring physicians, not broader RHIOs or health information exchanges, says Mark Holland, program director, health care provider research, at Health Industry Insights, a unit of IDC, Framingham, Mass.
Competitive pressures are forcing hospitals and their parent delivery systems to invest in networks, Holland says. They want to use these networks to make it easier for community physicians to refer patients for hospitalization. This is becoming more urgent, he says, as fewer patients are hospitalized because of the continuing shift to outpatient care.
"Most physicians in our area admit to two or three hospitals," notes Matt Ebaugh, CIO at Silver Cross Hospital in Joliet, Ill, just south of Chicago. "We knew that if we made it easier for physicians to access data, it would be a way to bond with them and offer us a temporary competitive advantage."
Ebaugh believes that, ultimately, a broad HIE will serve the region south of Chicago, and most patients will have personal health records. But until that day comes, his 306-bed hospital is building its own network links to local physicians.
Hospitals seeking to improve their reputations as centers for excellence, especially for cardiology or oncology, are particularly motivated to build their own electronic links to specialty physicians, says Michael Mytych, principal at Health Information Consulting LLC, Menomonee Falls, Wis.
Some hospitals and delivery systems are taking ambitious steps to facilitate the two-way exchange of clinical data with group practices. For example, a few pioneering doctors affiliated with Catholic Healthcare West can send data to some of its hospitals and receive information on hospitalized patients.
Others, Mytych, notes, are taking a simpler approach. For example, they're enabling doctors to view hospital data in a read-only mode. "That's the poor man's HIE," he says. "But it's better than driving in the dark without your headlights on."
A growing number of hospitals are serving as application service providers to area physicians, giving them remote access to outpatient electronic records systems via the Internet to help jump-start clinics' automation efforts. These hospitals' ASP efforts are designed to pave the way for eventual clinical data exchange.
The cover story of the August 2008 issue of Health Data Management provides an in-depth look at the hospital as a network hub. To read the full story, click here.
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