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How do we build buy-in for a RHIO?

Achieving buy-in from the stakeholder community is essential for the success of a RHIO. These stakeholders include data providers, data users, and funders. In many cases, an entity, such as a hospital, may encompass all three constituencies. In other cases, an organization, such as a community health center (CHC) without IT staff, may be only a data user and not have the capabilities to provide data. Some RHIOs have also received funding support from employers and health plans, though they are not providing or using the data.

To create a successful RHIO, all stakeholders must find that the benefits (e.g., reduced time by staff searching for lab results in the mail) outweigh both tangible costs (e.g., legal expenses) and intangible expenses (e.g., loss of data control). As part of the development plan, a marketing strategy is essential for the sustainability of the health information exchange organization and should note the advantages of sharing data and address the concerns of stakeholders, especially around privacy and security. 

To build buy-in, the health information exchange organization must first understand the dynamics of the provider community in their targeted region. Individual physicians, clinics, and hospitals, need to be comfortable with contributing clinical data that would make the data exchange valuable to other members. The members must be also willing to fund the operating costs of this effort. 

Providers often are concerned about patient data misuse or loss of a competitive advantage. In areas with perceived resistance to clinical data-sharing, starting with a narrower focus such as the ability to exchange lab results can provide the basic infrastructure. With wider stakeholder acceptance of the technology, the scope of electronic clinical messaging can then be expanded. Also, a technical infrastructure can be created that addresses security or competitive concerns, such as not aggregating patient level data. However, when making these types of determinations, the health information exchange organization should consider whether the potential for misuse outweighs the limited value of the data shared.

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