Real Participation in RHIO and HIE

Everyone seems to love talking about RHIO, HIE and all of the other various initiatives happening around sharing patient health information amongst doctors. This weekend, I want to open it up to you the readers to get an idea of what type of participation you’ve had in an RHIO, HIE or other clinical data exchange.

Are you participating in one now? Do you like it? Do you hate it? In fact, what do you like and what do you hate? Do you use an EMR to interface with the exchange? What’s the interface like? How much work is it to manage the interface?

I’d also be interested in hearing about people who are working through the process now. Where are you at in the process? What’s holding you up from making this happen?

Let’s help educate each other on what’s happening with something that I think we can all universally agree is important and INCREDIBLY challenging.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Hey John,
    Great topic. I just finished up assisting a client in implementing a data exchange with their EHR and the state’s HIE and wrote a blog article on the experience:

    I agree that RHIO and HIEs are gaining steam. Perhaps it is the fact that companies like Navinet are offering to subsidize the cost for the architecture and backbone infrastructure. Beware though, as someone will have to assume the cost of said implementation and a caution that a transactional fee model may be associated with that type of implementation.
    Currently the client EHR is feeding data to the HIE and not vice-versa. I surmise that if it were not for the fact that the HIE offered to subsidize the cost of interface development, there would be little incentive for the client to participate.

    Given the application programming interface to the client’s EHR (Allscripts Enterprise EHR), a separate interface to/from will be required for each flavor: (inbound and outbound results, inbound and outbound document, regsched, etc – a full list can be found here: I just finished up assisting a client in implementing a data exchange with their state’s HIE and wrote a blog article on the experience:

    The ideal scenario would be one in which CCD/CDAs are used to exchange information between the EHR and HIE, however we are not there yet, as HL7 tends to be the standard of choice in healthcare data exchanges.

    That said, I should touch on the fact that the key pieces to an exchange between an EHR and an HIE are patient matching and filtering of data (both inbound and outbound).

  • Great question! I recently had all four heads of the major hospital hospital systems in our area in one room, and they looked pained when I brought up the topic of establishing an HIE in the Toledo metro region. I don’t think they’re very keen on exchanging data with one another, as they’re competing with one another for patient’s healthcare dollars, and they don’t want to make it trivially easy for their clients to leave. I.e., they view creation of a local HIE as lowering a barrier to exit for their clients.

    From a capitalist perspective, I think they’re arguably correct. From a socialist/humanist perspective, this leaves something to be desired. And Toledo can’t be the only community with this problem. Are there any federal or state laws that require hospital systems to participate in HIEs?

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