The outlook for the creation of a self-sustaining national health information network dimmed after a decision by the Patient Safety Institute to close its doors.
The Patient Safety Institute ceased operations last week after six years, citing a lack of investment opportunities to test its locally grown information network on a national scale.
But the institute was not the only health information network to fold in 2007. Several regional information exchanges could not sustain funding despite claiming to have strong participant support, and recent closures in Portland, Ore., and Pennsylvania suggest organizations havent yet proven to the healthcare industry the need for everyone to be able to exchange data (Sept. 10, p. 32).
A sustainable business model is necessary if the healthcare industry wants to move forward with improvementsomething that has been difficult to prove for physicians, said Bill Hersh, professor and chairman of the department of medical informatics and clinical epidemiology at the Oregon Health & Science University, Portland. We have a poor business case for small practices to adopt electronic health records, since they pay the cost and others get the benefits. Same for the Patient Safety Institute and same for RHIOs. Those who get the benefit must be the ones who pay the cost, he said in an e-mail message.
The institutes technology was similar to that used by many other groups attempting to leverage networks, said Beth Just, president and chief executive officer of Centennial, Colo.-based consulting firm Just Associates. Her company works with healthcare systems to implement patient-identity management across differing medical records. Through her firm, she works closely with the Colorado regional health information organization, a statewide information network initiative.
The Colorado RHIO currently is piloting its network using a five-year grant from the Agency for Healthcare Research and Quality. That grant will run out in two years, after which the RHIO will be on its own. The organization is exploring sustainability models now, Just said.
Johnny Walker, former CEO of the institute, said in an e-mail message that the organizations model would have worked, but investors were cautious about the expense and unclear about a return on investment. This is where the project broke down because we could not secure the investment to demonstrate payer savings, he said.
The Plano, Texas-based institute estimated it would have needed more than $10 million for the national demonstration. We didnt find it anywhere, he said.