Lessons Learned from Santa Barbara

One of the most celebrated RHIO (Regional Health Information Organization) failures in the United States was the Santa Barbara County Care Data Exchange which ceased operations in December 2006. The California HealthCare Foundation has released an evaluation of the initiative titled The Santa Barbara County Care Data Exchange: Lessons Learned, which documents the issues leading to the failure and lessons learned for similar initiatives. From the Executive Summary:

The Santa Barbara County Care Data Exchange (SBCCDE) was once one of the most ambitious and publicized efforts to develop health information exchange in the United States, and was considered a model for emerging regional health information organizations (RHIOs) elsewhere. Nearly eight years after its inception, and several months after providing some data to clinical end-users, the SBCCDE ceased operations. Although the venture had developed a peer-to-peer technology infrastructure that enabled authorized physicians, health care organizations, and consumers in the region to access some electronic patient information security via the Internet, the once-promising exchange was unable to overcome major hurdles and thrive.

This case study looks at the history of Santa Barbara's RHIO and why it was not successful. It also presents lessons learned from that experience, briefly describes two other exchanges that have been more successful, and discusses the policy implications for nascent RHIOs elsewhere. Reasons why the project did not succeed include the lack of a compelling business case, distorted economic incentives, passive leadership among participants, vendor limitations and software delays, and due to a variety of factors, the venture's poor momentum and credibility.

This case study is required reading for eHealth risk specialists!