JAMIA: Is Doing Away with RHIOs Good for NwHIN?

An article published in the Journal of the American Medical Informatics Association on Jan. 21, questioned whether the federal government’s shift away from regional health information organizations (RHIOs) in favor of information exchange is best for the Nationwide Health Information Network (NwHIN).

Leslie Lenert, MD, MS, department of medicine, University of Utah in Salt Lake City, and colleagues wrote, “In the midst of a US $30 billion investment in the NwHIN and EHRs systems, a significant change in the architecture of the NwHIN is taking place.”

Prior to 2010, Lenert wrote, the focus of information exchange in the NwHIN was the RHIO but since 2010, the Office of the National Coordinator for Health IT (ONC) has been “sponsoring policies that promote an internet-like architecture that encourages point-to-point information exchange and private health information exchange networks. The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success, while making the NwHIN dependent on nascent technologies for community level functions such as record locator services.”

Lenert cited as an example of a "public good" implemented within many RHIOs the potential capability to quickly and automatically locate and retrieve most relevant EHRs for a patient, which “was a critical design feature of early RHIOs.”...