A Setback for Electronic Health Records?

One of the best-known organizations trying to electronically connect regional hospitals and doctors so they can share patients' electronic health records (EHRs) is calling it quits, dealing a setback to the Bush administration's strategy to build a national network of EHRs. The Santa Barbara County Care Data Exchange, established in 1999, says it is closing its doors because some members of the exchange were concerned -- despite the information security controls that were in place -- about liability issues if patient health data was accessed by unauthorized users, according to Government Health IT. Funding also was an issue.

The exchange is known as a Regional Health Information Organization, which the Bush administration says is the foundation for building its National Health Information Network. The Office of the National Coordinator for Health Information Technology, part of the Department of Health and Human Services and in charge of the EHR initiative, envisions doctors logging onto the NHIN to call up patients' health records, no matter where the record is stored in the United States. "Our first step [in developing the NHIN] is to foster regional collaborations among health care entities so that a patient's information can be securely stored in the local community but is electronically accessible to those involved with providing their care in that community," according to a National Coordinator's Web site. "As ... more regional collaboratives -- coined Regional Health Information Organizations or RHIOs -- are formed, a common approach for their development is needed to support the overall goal of health care data exchange among them."

President Bush has set 2014 as the deadline for having most Americans' health records available on the NHIN, but the closing of the Santa Barbara exchange shows the difficulties the Bush administration faces in developing the network. According to its Web site, the Santa Barbara exchange "is one of the first and most widely known health information exchange[s] in the United States. ... It has ... developed innovations in components of health information exchange that are now being replicated throughout the United States. The county has served as a laboratory and teaching center for other regions interested in health information exchange, hosting more than 100 visitors last year and publishing detailed lessons from its successes and failures."

Last fall, Spectrum Magazine, a publication of the Institute of Electrical and Electronics Engineers, reported on what the Bush administration must overcome to build the NHIN, citing interoperability and privacy concerns as major obstacles.