RHIO and HIE development is a highly complex undertaking and not for the weak of heart. As I was driving into Los Angeles the other morning I encountered one of the routine "sigalerts". For those of you who have never been in California and live in a rural area I will explain this is a system of alerts from the Callifornia Transit Authority whereby notifications are sent out by television, radio and internet about blocks in traffic due to "events" such as accidents, toxic waste, police activities, construction activites, etc. Recently my oldest son, who has rapidly passed me by in the world of high tech (he has smaller thumbs than I do) and I were in the car together and as we bogged down and did not move for several minutes, the GPS asked if we wanted to plot an alternate route, and suggested about five different ways around the thrombosed artery.
I believe that the current roadmap is flawed as designed and hoped for by several agencies with good intent. Our Health Train Express is now in a "sigalert status" The problems with "roadmap" is that requires funding from unknown or difficult and confounding sources such as grant making organizations ranging from county to state and federal and combinations thereof. Often times these grants are tied to the momentary "political expediency" of the moment, ie, Katrina, Homeland Security, Bioterrorism, and even "Global Warming"
Often and most of the time it is totally dependent on the whim of the moment of legislatures both federal and state, impacted by competing budgetary priorities of peace and war. education, immigration issues, and more.
The "road not taken" as Robert Frost so aptly stated requires a minimalist approach with obtainable goals that step through the process. Rather than swallowing the whole cow, we must take small bites, chew an digest each piece individually. This rather graphic and seemingly unrelated metaphor sums up a new roadmap.
It is difficult for providers and hospitals to grasp the RHIO concept because it is rather like dropping an Atom Bomb. It overwhelms most executives who are fully engrossed in just running their institutions on a day to day basis.
Developing one functionality that would maximize a return on investment in one area as a demonstration without disruptive technology gives an HIE a "foot in the door" When a user (provider or hospital) subscribes to this service for a relatively small sum the revenues derived and create cash flow for the HIE as a revenue cycle. The single functionality must demonstrate it's own cost effectiveness and ROI in less than one month. It must be demonstrated as successful in a regional pilot program. It must be self funding, elective and non binding without contractual obligation, and also offered as a 30 day free trial.
More on this later........