I do not see a long-term future for Regional Health Information Organizations (RHIOs). There is no compelling reason for most healthcare practices to participate in an RHIO and in many cases, such participation may compromise a provider’s competitive position. Health Information Exchanges (HIEs) on the other hand will see localized success as these are created by providers, in their own self-interest, to share information among their network of partners to facilitate workflow and optimize business processes.
Today, there are no PHRs in the market that have the clout to directly compete or subsume an RHIO or HIE. Google, and its impending PHR release, may change all that but we’ll have to wait and see.
That being said, a new entity/concept is on the horizon in the likes of Dossia and Microsoft’s HealthVault. These are not PHRs, but what I refer to as PHSs for Personal Health Systems. They are structured much like an RHIO to aggregate all the various bits of a person’s health record (labs, images, clinical notes, medications, claims, etc.) into a secure data repository. This data would then be serve up, via an application programing interface (API) layer, into a Personal Health Application, of which PHRs are a subset. More information about PHSs and how they are intended to work can be found at this previous post on Dossia’s “utility” model.
What I like about the PHS model is that unlike RHIOs, or for that matter HIEs, it is consumer (and in the background employer) driven. Employers have a strong and vested interest to see the PHS model succeed, and I believe in time, consumers will as well. But only time will tell if the PHS model will indeed succeed as the healthcare sector has woefully under-invested in IT to date and without digital data, even PHSs will struggle to create sufficient value for their users and sponsors.