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Florida's "Network of Networks"

The Florida Health Information Network (FHIN) operates at the community level, with the state supporting and encouraging local collaborations focused on health information exchange, particularly the development of regional health information organizations (RHIOs). In this way, Florida aims to create a "network of networks" to improve patient care. [6]

"We want to see Florida's RHIOs succeed," says Lisa K. Rawlins, one of the original architects of the FHIN and current director of quality and process improvement at Broward Health. "Success requires political leadership to encourage collaboration. Collaboration builds broad-based stakeholder knowledge and buy-in. And stakeholder support provides consistency through political change."

Florida's strategies for developing its network include: 1) funding grants to promote the development of RHIOs; 2) integrating the RHIOs with a state-level server that will manage data exchange among RHIOs and other state and federal databases; and 3) creating a not-for-profit organization to maintain the Florida Health Information Network and set standards for the RHIOs.

In May 2006, the Florida legislature provided $3.5 million in funding over three years for the Florida Health Information Network Grants Program. FHIN grants provide start-up funding to help local health information networks get off the ground. The Governor's Advisory Board oversees grant evaluations and recommends award recipients to the Secretary of the Agency for Health Care Administration. All grant funds are matched dollar for dollar at the local level.

One primary goal of the FHIN is to supply local RHIOs with technology and business services such as infrastructure and software integration, data mapping and standardization, marketing support, and data analysis to achieve economies of scale.

Three Florida RHIOs—Big Bend in Tallahassee, Palm Beach Community Health Care Alliance, and Tampa Bay—currently operate networks that can be accessed by participating hospitals and physicians. Four other organizations have received FHIN grants and are in the process of implementing information exchange within their networks.

"In addition to funding," says Rawlins, "from the beginning we wanted to load as much state information as possible into each RHIO. Our goal is to make public health and Medicaid information available to each RHIO. When doctors join, they need to see information that matters—vaccination registries are a good example—anything useful so they'll use the network and become supporters of health information exchange."

For More Information
Contact: Lisa K. Rawlins, Director, Quality and Process Improvement, Broward Health, [email protected], 954-355-5986.

[1] eHealth Initiative, "Definition and Select Characteristics of HIE Initiatives," August 2005 (
[2] eHealth Initiative, "Improving the Quality of Healthcare Through Health Information Exchange," results from the Third Annual Survey of Health Information Exchange Activities, September 25, 2006 (
[3] Agency for Healthcare Research and Quality (AHRQ), "Evolution of State Health Information Exchange: A Study of Vision, Strategy, and Progress," January 2006 (
[4] Primary source: Anthony Rodgers, "Transforming Healthcare Delivery with HIT: Arizona," presentation at the National Academy of State Health Policy Annual Conference, October 2007 (
[5] "Medicaid Health Information Exchange Utility Project," State of Arizona Medicaid Transformation Grant Proposal, September 2006(
[6] Primary source: Lisa K. Rawlins, Florida's Role in Developing Health Information Exchanges, presentation at the National Academy of State Health Policy Annual Conference, October 2007. "Regional health information organization" and "health information exchange" are often used interchangeably. A regional health information organization is a group of organizations with a business stake in improving the quality, safety, and efficiency of health care delivery. RHIOs are the building blocks of the proposed National Health Information Network initiative proposed by David Brailer, M.D., formerly the National Coordinator for Health Information Technology.

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