Readers of this blog may recall that I am not a big fan of RHIOs. In my opinion, they have a number of significant flaws including "no defined business model to support [themselves] once government funding [runs] out" as well as the impractical goal of the integration of clinical data across hospitals within a region. These same hospitals are frequently unable to achieve a high degree of integration of their very own data. Cerner's Winona Health project is now being cited as a RHIO success story (see: A Tale of RHIO Success). Below is an excerpt from the blog note that makes this claim:
Nearly as fast as regional health information organizations (RHIOs) cropped up a couple of years ago, they have started to disappear or at least scale back their plans due to financial difficulty. But there are some success stories to be found for those who look hard enough. Try, for example, Winona, Minnesota, where a small network is thriving. At MedInfo 2007...the world got a tale of success from Winona Health. When the United State’s first health-IT czar, David Brailer, called for interconnecting clinicians with what he called RHIOs in 2004, Janice Turek, clinical director of information systems at Winona Health, knew exactly what he was talking about. “We had already connected a region,” said Turek, a registered nurse. “We have been able to sustain and develop informatics in a small community.”...The strategy for Winona Health was quite different from most other provider organizations. Winona started in 2000 with a Cerner patient Web portal and personal health record (PHR) to build the foundation for an electronic health record (EHR). “This is when we actually married the Cerner Corp., and it’s been a wonderful marriage,” said Turek. Winona Health also helped other organizations in and around the town of 30,000 become Cerner customers because a common system would facilitate data sharing.
Although I believe that Winona Health is, and will continue to be, very successful, I personally would not classify it as a RHIO. You may want to read about CHINs in the following article that was published in 1999: How A Community Health Information Network Is Really Used. Below are the reasons why I think Winona Health is a CHIN:
- As noted above, Winona Health dates back seven years. This was the era of the CHINs, antedating the evolution of RHIOs. Winona was always community-based and it is even referred to in the article above as "informatics in a small community."
- The town of Winona, Minnesota, was hand-picked by Neal Patterson, CEO of Cerner, as a community laboratory to test his ideas about healthcare IT integration. Winona is a small, relatively isolated. relatively affluent small town in Minnesota "where all the women are strong, all the men are good-looking, and all the children are above average."
- The Winona Health recipe of success involved a single committed vendor, a single community hospital, and a buy-in from many of the town's physicians to integrate their clinical information. Moreover, Cerner personnel provided significant technical and financial support because a failure of this project would have been untenable option for the company. Note the reference to Cerner "marriage" above. Few, if any, RHIOs are the handiwork of a single vendor.
- Although there was talk in the early days about cloning Winona Health to other communities, this has never occurred, to the best of my knowledge. This was probably because this idealized Winona scenario could not be replicated elsewhere. Like the perfect but fragile hybrid rose, it would never flourish when pulled out of the Minnesota soil where it was born.
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