Regional Health Information Exchanges (RHIOs) have been around for some time. They are aimed at improving treatment for patients by coordinating images between different providers -- in a given region -- in a more efficient way. Through a protected portal, both specialists and primary care doctors can see radiology reports and the images those reports are based upon. DOTmed News spoke with Ted Kremer, executive director of the Rochester RHIO, to learn more about the tool, and what's being done to make it better.

DMN: How did the Rochester RHIO come about?
TK: The Rochester RHIO was developed by a collaboration of regional employers, health insurers and healthcare organizations. The RHIO benefitted from start-up funding from New Your State, along with funding from stakeholders in the business and health sectors of the local community.

DMN: How widespread are RHIOs across the country?
TK: There are 11 RHIOs in New York State, and around 200 nationwide. Many states are working to develop state level health information exchanges.

DMN: What's the criteria for hospitals and providers to become part of an RHIO?
TK: For the Rochester Region, all the hospital systems in the 13 county region participate, as do any of the independent practices who choose to participate. All participants sign a Data Sharing Agreement. In doing so, participants agree to conform to the privacy and security regulations of the RHIO.

DMN: What's the difference between a RHIO and say something like RSNA Image Share?
TK: The Rochester RHIO includes an image exchange. Radiology reports sent to the RHIO from hospitals and independent radiology centers include a link for the RHIO user to view the associated image via a diagnostic quality viewer. When a RHIO user seeks out patient information, the image is just a part of the patient medical information available on the HIE. The physician can also view a more complete picture of their patient, including lab results, hospital discharge summaries and past images from other providers. Products that share images only cannot offer the patient context that physicians often require.

DMN: How does something like this help providers meet meaningful use, particularly stage 2 meaningful use?
TK: The RHIO provides several options to assist providers meet MU, including electronic ordering and delivery of clinical results, electronic access to images and electronic transmission of transitions of care information.

DMN: Can you provide any anecdotal evidence about how this kind of imaging sharing benefits patients and providers?
TK: There is evidence that imaging sharing can be critical to improving the quality of care and reducing health care costs.

1. A patient arrives at a rural hospital ED with cardiac symptoms. After a series of tests, the rural hospital decides to transfer the patient to an urban hospital for a higher level of care. When the patient arrives at the urban center, the ED physicians can access the tests that have already been completed, saving time, costs and radiation exposure.

2. A patient in the hospital has neurological symptoms. By viewing past MRI images, the physician can compare newer images to see regions of significant change. The image exchange supports diagnostic efforts with more information.

3. A surgeon needs to have access to all radiology images before surgery on a patient. Rather than counting on a patient to bring a CD, or finding out the CD won't load, the image exchange is always available for access to multiple images.

DMN: You have recently enhanced the Rochester RHIO. How do you think it will help providers and patients?
TK: The new image exchange provides faster access, and it adds an enhanced image viewer that allows the user to view multiple images. This viewer will allow two physicians at different sites to electronically collaborate in reviewing a image.