Maryland program creates new framework for sharing EHRs

A new framework to assist all states and Washington, D.C., create "self-sustaining and effective networks" for exchange of electronic health records (EHRs) has been developed by the Center for Health Information and Decision Systems (CHIDS) at the University of Maryland's Robert H. Smith School of Business.

In its work, the center assessed the D.C. Regional Health Information Organization (DC RHIO), Washington's primary health information exchange (HIE). The DC RHIO, managed by a primary-care association and funded by the city government, has been rated among the top 20 percent nationwide as a fully operational exchange.

Nationwide, approximately 200 HIE initiatives have been started, but only 18 currently have revenues and cash flow from operations that exceed expenses, according to the center. In order for the DC RHIO to achieve a level of sustainability, CHIDS recommended that it construct "a hybrid revenue model"--based on subscriptions, which include a set of pre-determined services, and fees for additional services.

In its assessment, CHIDS found that the DC RHIO has made progress in most of the dimensions of the HIE Assessment Model. HIEs are evaluated on five key performance components: the value creation and sustainability of its business model; organizational structure and decision-making processes; technology; community engagement; and trust in the system.

"HIEs are complex organizational forms that engage many stakeholders, sometimes with conflicting goals. The framework is designed such that it can address the multiple dimensions along which an HIE needs to exhibit superior performance," Ritu Agarwal, director of CHIDS said, according to the announcement. "As more HIEs become operational, the tool can be used to compare and benchmark performance."

For more details:
- here's the announcement

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