More and more, it becomes clear that the greatest risk to major eHealth initiatives has nothing to do with privacy, security or other risk issues... Its the business model. Unless there is a clear value proposition for each of the major players in an eHealth program, it will not survive. Scanning the news this morning I came across this post from Modern Healthcare Online titled RHIO experts talk problems, future of movement. Some notable quotes from the article:
It's not yet clear if the incentives exist for healthcare organizations to share information.
One problem with RHIOs as they often are proposed is that they provide the bulk of their benefits to patients and health plans, people and entities that according to our current healthcare payment structure either don't pay at all for RHIO startup and operational costs or pay a disproportionately small share.
It does not make sense for a RHIO to have a consumer-centric model. It's a noble idea to say put the patient first, but what you have to have are business plans within the provider community.
Another common stumbling block to RHIOs is an unwillingness of likely participants to collaborate because of provider and payer rivalry and mistrust.
Too many eHealth initiatives go forward on the assumption that with the right technical architecture and interoperability standards, success is a slam-dunk. While important, what will sink the initiative is one or more stakeholders not believing that it is worth their while to participate.
I was intrigued about the comments concerning the idea of putting the patient first. While it is a noble thought, and while we would do well to structure our architectures based on that premise, eHealth must provide direct, tangible and measurable benefits to those who have to foot the bill or expend the energy effort necessary to ensure success.
Its the business model stupid!