California Regional HIE Meeting

The meeting was held two weeks ago in Los Angeles. As an event, it was a strange brew of scripted posturing from CalRHIO and abrupt intrusions of reality due to many inconvenient questions posed by attendees who represented operational HIEs. From my perspective there were no revelations at the meeting. CalRHIO continued their Quixotic quest to impose a misunderstanding of eHealth technology on the state, while the meeting held a room full of HIEs who knew too much to simply accept the self-serving inaccuracies that litter CalRHIO's common narrative in presentations, press releases and in meetings like this one. For example:

• The typical CalRHIO narrative claims that when they build an HIE service, at some future point, it will be a first for California. Over the past two months CAeHC has developed a definitive inventory of HIE efforts within California. When CAeHC launched in February, the inventory showed 4 operating HIEs. Now, two months later, the inventory shows 8 known operating HIEs in California, none of which are CalRHIO.
  


• The recent press release from CalRHIO about new HIE services in Orange County conveniently omits any mention that there already is an operating HIE service connecting the emergency rooms in Orange County. The press release says the planned launch by CalRHIO of a small portal in Orange County this summer will be the first county-wide HIE service, when in fact if it launches in July (as promised) the new service from CalRHIO will be the second county wide HIE service in Orange County, and it will join several other county wide HIE services already in operation in other counties in California. The Orange County press release is typical of inaccuracies in CalRHIO's narrative.


• CalRHIO continues to misunderstand the NHIN gateway architecture by asserting incorrectly that the CalRHIO web service from Medicity will be needed for all small HIEs in the state to connect to the NHIN. This assertion by CalRHIO is directly contradicted by the current federal architecture for the NHIN, in which any HIE in California that operates an NHIN gateway will connect directly to the NHIN without CalRHIO.


• CalRHIO said that if they cannot be the official statewide HIE, then they will close their doors, which is silly, because there is still a role for CalRHIO even if they don't yet understand the NHIN gateway architecture

So the short version of the meeting is that CalRHIO found itself in a room full of its peers, and instead of taking the opportunity to communicate openly, CalRHIO maintained its imperial, top down approach towards HIEs across the state that are already delivering clinical data (unlike CalRHIO). Here's the list:

1. Redwood MedNet
2. Virtual Clinical Network of Partnership HealthPlan
3. ACCEL
4. Santa Cruz
5. EKCITA
6. Long Beach Network for Health
7. Kaiser Permanente
8. Orange County MSI

In the end, the meeting was another missed opportunity for CalRHIO to harmonize their message with the eight HIE projects in the state that are already operational. Instead, rather than openly collaborate with other HIEs in the state, in this meeting CalRHIO described a clearly inaccurate version of events. When called on these inaccuracies by participants at the meeting, CalRHIO sought to talk them away. People I spoke with after the meeting were disappointed by the continued stonewalling from CalRHIO.

As the next phase in the NHIN unfolds this year, fueled by HITECH funds, and as the 8 operating HIEs in California are joined by the 10 planning HIEs, and as even more HIE projects in this huge state emerge, CalRHIO will find a robust community of peers available to collaborate on improving health care for all. This is not a question of if but rather is only a question of when CalRHIO will drop their mistaken assumptions that (1) they are in charge of the state or (2) are in any way essential to the NHIN, when in fact they are just one HIE among many.

Call To Action
In the next post I'll detail the Call to Action that was published earlier this week (on Monday) by the California eHealth Collaborative, which asks all communities in the state to articulate the actual, known, on-the-ground eHealth activities. Far more than the inconclusive regional meeting hosted by CalRHIO in Los Angeles, the CAeHC statewide survey will show how many communities are hard at work developing an eHealth infrastructure for California.