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Building a Foundation

BCBSM works toward a statewide electronic health record system.

Regional Health Information Organizations (RHIOs) have the potential to deliver better service, faster claims processing and easier access to healthcare records with less cost through the sharing of electronic health records (EHRs) among insurers, hospitals and physicians. That's why Detroit-based Blue Cross Blue Shield of Michigan (BCBSM; total revenue of $15.3 billion) is helping to lay out a blueprint for the Michigan Health Information Network, which is charting a plan for establishing a statewide EHR system. "I think we will see a breakthrough in interoperability in the next couple of years," says Kathleen Wodecki, manager for the Electronic Business Interchange Group (eBIG) of BCBSM.

BCBSM conducted a statewide study, released in March 2006, that evaluated vendors' current record-keeping technologies in hospitals and doctors' offices and ways to connect them into an interoperable system.

Inconsistencies in computer systems, data elements and medical vocabularies were found to be among the challenges to developing EHRs in Michigan. And a lack of standard nationwide policies for EHR adoption has stymied the creation of RHIOs. "[The industry] needs to agree on standards ... so we can leverage these systems" to create an RHIO network, says Wodecki. Industry analysts concur. "Fear of investing in the wrong technology when the standards could change keeps providers from moving toward the creation of RHIOs," says Eric Brown, research director of healthcare and life sciences, Forrester (Cambridge, Mass.).

There is risk involved, agrees Kelly Cronin, director of programs and coordination for the Office of the National Coordinator for Health Information Technology (ONC; Washington, D.C), part of the Department of Health and Human Services, which is working toward the nationwide implementation of an interoperable health information technology infrastructure. But she reports that the ONC is working with the American Health Information Management Association (Chicago) to extract best practices from nine established RHIOs to form industrywide RHIO standards by August 2006. In the interim, Cronin recommends insurers align themselves with state medical associations to help establish the infrastructure and financial model for future RHIOs. --Maria Woehr

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