Health data exchanges still face critical challenges
Regarding the March 3 editorial (“Keep the public health information exchanges open,” p. 25), public HIEs are a wonderful concept, as were CHINs (community health information networks) and RHIOs (regional health information organizations) before them. While technology and the Internet have taken some of the challenges from these information-sharing efforts out of the equation, two substantial issues remain.
HIEs fundamentally lack a robust revenue model. Patients in other industries are known as clients. Getting businesses to pay to publish their clients’ information for competitors is a hard sell. Also, consumers have an inherent aversion to allowing their most personal information to be stored or accessible via a quasi-governmental entity.
The HIE concept needs to be re-envisioned as a consumer-centric model where control and access are based around the individual or authorized caregiver (mom, adult child of a frail elderly parent, etc.). Even this model lacks a robust source of revenue, but at least issue No. 2 is addressed. And consumers who learn to own and control their medical record will find conveniences that force providers to participate—like not having to fill out the long form on that darn clipboard.
The ONC seems to be working in this direction. Dr. Edward Fotsch
Chairman PDR Network Sausalito, Calif.