Policy- vs. Market-Based Reform: RHIOs as a Case Study – Brian Klepper

BrianAs Anonymouse insightfully commented, the Harvard team’s RHIO study in Health Affairs is very telling
about the barriers facing do-gooder health care projects. That said, I wanted to add two comments.

First, while RHIOs are unquestionably good public policy, what they might accomplish can be seen as counter to their interests of many organizations expected to support them. (The same can be said for EHRs, by the way)

Second, this is why health care reform will emerge not from within health care and not from policy, but from the marketplace, driven by non-health care interests.

Read the rest over at the Health 2.0 Blog

2 replies »

  1. “because health care policy has been effectively captured by the industry, rendered meaningful policy-based reform all but impossible.”
    I don’t know how Health 2.0 will somehow pry control from the industry and put it into consumers hands where we’ll all live happily ever after. The bills (and campaign donations) are still being paid for by the industry, and profits that Health 2.0 needs to survive will have to come from the industry as consumers have grown to expect internet information for free. I think it will evolve as the rest of the internet has, sites supported by sponsors that push their own products and where a search yields a million hits that no one has the time or expertise to evaluate. And as usual when trying to get opinions and real life experiences from web communities you get a 1000 different opinions, with no clear direction on YOUR problem, along with industry shills hoking their own product thrown in for good measure. Search sites will also make sure their biggest sponsors come up first on the list. And how hard is all this going to be for such a complicated discipline as individual health problems.
    As tcoyote said why would the industry want to stop duplication and waste when it’s soooo profitable. Like the defense industry wanting to end war.

  2. Judging by the thick swarm of posts on this issue, the RHIO is not top of mind in the health policy/health info community. The RHIO is a thirty year old idea, brought to you by the same people who brought you Health Systems Agencies in the 1970’s. Actually, it’s a reborn version of CHIN, which died a similar death in the 1990’s. Even the mushy folks in the foundations expect that an idea they fund will eventually find other adoptive parents at some point.
    You don’t need Health 2.0 to do this. You need to be able to write the core data elements one would like to know about a brand new, completely unconscious ER patient (meds, allergies, chronic condition risks, recent test results if available) on a flash drive or (coming soon, a memory spot) on the person’s car or house key chain, and be able to read and update anywhere the patient is seen. What you need to do this are data standards, a defined core record, and USB readers/writers in care sites and pharmacies. Not rocket science.
    BTW, the idea that “duplicative testing” somehow disappears w/ perfect personal health info is a joke- testing is still economically driven, and people will find excuses to test even w/ a perfectly functioning PHR.