2007 RHIO Finance Survey Launched

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The 2007 national Survey of Regional Health Information Organization (RHIO) Finance is being distributed to health information exchanges across the nation between March 23 and April 20. In 2006, the only study to focus specifically on how RHIO startups are funded, and how the organizations are sustained over time, found evidence of an emerging sustainable business model, and identified sources of support among the fifty RHIOs probed. Persons involved in RHIOs may take the survey online.

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Regional Health Information Organizations (RHIOs) offer to solve a set of growing healthcare problems. By enabling the exchange of vital medical information between all the providers who participate in a patient's care, RHIOs promise not only to help contain costs, but also to improve safety and effectiveness of that care. But, after decades of fitful development, will the concept of an electronic health information exchange ever become a sustainable, solvent business? Following the recent failure of one of the earliest and most mature RHIOs, that question hangs over the dozens of ambitious efforts currently underway across the US. "The Survey of Regional Health Information Organization Finance," now in its second year, will provide a timely examination of the financial environment as it happens "on the ground" in these various state and regional laboratories.

Generally, RHIOs serve the hospitals, physician groups, laboratories and other healthcare organizations in a local or statewide area, to provide a way to share medical records of the many thousands of patients they treat. The federal government has made the establishment of RHIOs a top US healthcare priority, in a long-term effort to build a National Health Information Network (NHIN). The 2006 survey revealed that the lion's share of RHIO financial resources were coming from government and hospitals in the form of grants, but many RHIOs plan to become self-sufficient through fees charged to member organizations for access to patient records. [See RESOURCE LINKS following this release.]

The survey will help answer important questions about how RHIOs are addressing funding challenges at the different stages of development. For this reason, all RHIO organizers are encouraged to participate, regardless of the organization's stage of development. Multiple individuals from the same organization may complete the survey. The streamlined questionnaire does not require the entry of detailed accounting data. It can be filled out by anyone familiar with the organization's governance, service offerings and revenues, if any. Data will be reviewed from a broader nonprofit finance perspective, and analyzed to shed light on the following questions, among others:

  • How do finances differ during startup, transition and production phases?
  • What forms of contributed and earned revenues are significant at what time?
  • How is the business model evolving?
  • What funding sources are the best prospects to fund a new RHIO project?
  • How are strategic decisions made?
  • How is capital leveraged to create revenue-generating operations?
  • What mix of services and fees are successful RHIOs using today?

A key finding of the 2006 survey was an ongoing reliance on grants and/or other forms of contributed income as the organizations mature. While 68% said that they either were or planned to be self-sufficient, more than 80% in each stage of development said that they anticipated applying for grants. Only 44% of RHIOs that self-identified as being in "mature production," the most advanced stage of six self-identified stages of development, said that they had achieved operational self-sufficiency. Nearly 90% of the self-supporting mature RHIOs said that they still anticipated applying for grants. 2007 data may help RHIO funders and trading partners understand evolving needs.

A free public summary, a special report to qualified survey respondents, and a full-scale report analyzing the data will be available in June. Report materials will deliver practical methods to optimize startup and near-term funding, as well as ongoing financial stability. Survey results will provide new wisdom from actual practice, and will help RHIO planners focus their efforts on activities that others in the field are finding most fruitful. The deadline for completing the survey is April 20.

Participants in RHIO projects at any stage of development are encouraged to complete the questionnaire between March 23 and April 20, 2007, available online at http://www.hittransition.com.

The Survey of Regional Health Information Organization Finance is privately funded, and is conducted by Healthcare IT Transition Group.

Healthcare IT Transition Group (HITTG) a technology, policy and finance consultancy that works with organizations to reduce the cost and improve the quality of healthcare through the use of information technology. Clients include healthcare providers large and small, software developers and technical services companies, and some of the nation's largest health plans. Healthcare IT Transition Group has worked for sixteen years to reduce the cost and improve the quality of U.S. healthcare through the establishment of interoperable information technology standards.


Michael Christopher, Lead Investigator

(918) 406-3998


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