December 11, 2007 -- A national system for sharing electronic medical data is a long way off, suggests a new study, which found that only a fraction of regional attempts at data sharing networks have been successful.
While a national medical data network has been proposed as a solution to everything from improving quality of care to cost control, the experience of regional networks suggests that system compatibility issues and financial difficulties will put a national network out of reach for the time being, according to the analysis.
The study, conducted by a team of Harvard University researchers and published online in Health Affairs, found that more than a quarter of the 145 regional health information organizations (RHIOs) existing in July 2006 were defunct by early 2007. Of the 83 non-defunct RHIOs that took part in the study, only 32 were actively "facilitating clinical data exchange," within a medical network. The other networks were either stuck in the planning stages of their operation, stalled for lack of funding or only facilitating sharing between a few independent groups, not a network, the study found.
"These findings suggest that nationwide electronic clinical data exchange will be much harder than what many people have envisioned," lead study author Julia Adler-Milstein said in a news release. She also said the findings subvert the traditional thinking on a national data network: that it would begin as a series of regional networks that would join together over time. Instead, regional networks have only seen tepid support, making it unlikely such a network would branch out nationally.
Of the 32 RHIOs that were able to facilitate data exchanges, 12 were only doing so in small geographic regions. The remaining 20 RHIOs were focused primarily on test data (85 percent), inpatient medical histories (70 percent) and outpatient records (60 percent). Fifteen percent were only exchanging one type of data.
But the financial news for those 20 networks that carry out their mission isn't much brighter, as many of these networks are still heavily reliant on grants, one-time financial contributions and in-kind payments, even after they become fully operational, the study found. Just 65 percent of the 20 up and running networks could claim subscription or transaction fees as a "substantial" source of support. The study's authors said that RHIOs' floundering in the free market makes the case for greater government involvement, either in the form of financial incentives or direct assistance.
"Either we have to create the right market conditions or have much greater public investment, but the vision of a national health information network is unlikely to come to fruition without one or the other," said co-author Ashish Jha in the news release.