NYeC finds 'public utility' model works well

NEW YORK  -  In the second half of 2011, the New York eHealth Collaborative (NYeC) shifted its role from a policy convener to a service provider that runs the health information exchange (HIE) infrastructure for the local HIEs and regional health information organizations (RHIOs) like a public utility. That shift was the "biggest necessary change" that is propelling the Statewide Health Information Network of New York (SHIN-NY) forward, according to Irene Koch, executive director of the Brooklyn Health Information Exchange (BHIX).

"Instead of allowing SHIN-NY to develop organically through just policy and have the RHIOs maintain their infrastructure independently, NYeC being able to offer a centralized, efficient model made a lot of sense to those of us who have patients who can really benefit from a deeper, more integrated system," Koch said.

While BHIX has a lot of data and value, it sits in New York City and serves a population that can easily access multiple HIEs and RHIOs. "The data needs to travel across a wider geography than just any one borough or region can achieve right now," Koch explained. Also, despite the handful of RHIOs in New York City, there's still a lot of fragmentation in terms of provider affiliation with different RHIOs, which impacts data flow. For example, some providers in Queens may have data flowing in BHIX, or some Brooklyn providers may have data flowing in another RHIO. 

"It was always important for us to move along the path toward inter-regional interoperability. For us, we want to be right at the lead for that," Koch said. BHIX is indeed at the forefront in NYeC's first step toward connecting New York State, as one of the first three RHIOs (along with e-Health Network of Long Island and THINC) in the downstate region to participate in the SHIN-NY. Part of BHIX's decision to participate was predicated on NYeC being able to combine and take over the infrastructure, which includes financing the operation of the infrastructure. Once more RHIOs come on board, SHIN-NY would evolve to a collective business model. Taking this step furthers BHIX's mission to deliver a product at better price points in order to benefit its members, Koch said.

"We knew from the start that things had to be flexible and that things would evolve," she said. "We're so pleased that the work we've done over these past several years is the kind of flexible infrastructure that will form a key component of the SHIN-NY going forward and we're very pleased at the same time to be among the first to partake from that and get the benefit of what shared data will mean for our providers and their patients."