Some good news and some bad news.  The bad: Northeast Pennsylvania RHIO bites the dust; the most recent casualty.  Tip of the hat to Gary Levin at Trusted.MD’s RHIO Monitor, who notes:

The failure of most RHIOs lies in the repetitive cycle of relying on establishing non-profit entities and reaching for a grandiose goal of regional and or national connectivity.  Babies must take baby steps.

Gary thinks NEPA RHIO will be resurrected in some form or another.

Many commentators have observed that successful RHIOs need to focus on building a shared vision (not just among the technogeeks, but among all the stakeholders) before beginning to build the IT infrastructure.  And, clearly, it can’t be done without big bucks. 

So on to the good news (well, I think it’s good): the California health facilities bond agency has conditioned its approval of Sutter Health’s nearly $1 billion bond issue on Sutter’s ponying up nearly $10 million for the California RHIO — to build some IT infrastructure for the RHIO and for rural providers.  That sort of creative arm-twisting strikes a familiar chord for me (as a former regulator) and could go a long way towards jump-starting RHIOs.  It’s more opportunistic than planned, but hey, $10 million is $10 million.

Now let’s consider the funding question further: Should the provider community bear the cost of rolling out a RHIO?  Shouldn’t them that realize a monetary benefit shoulder the burden?  That would mean contributions from payors — as has happened in Massachusetts, with significant funding for MAeHC coming from payors — and even liability insurance credits for the wired provider.  Who else should be tapped for contributions?

David Harlow