What is the role of federal and state government, if any, in ensuring that RHIOs/HIEs are sustainable?
While it is strongly within the public interest for patients to have access to their personal health information in a timely, effective and secure manner, there are many competing demands on state and federal funding, including education, infrastructure, and public health. We would be concerned that such a critical health functionality as HIE be dependent on annual appropriations by a state or federal body. However, governments can, with little adverse financial consequences to themselves, provide financing mechanisms, such as credit enhancements, that could improve the opportunities for RHIOs/HIEs to be sustainable. Giving appropriately constituted organizations official designations as the HIE provider for the state could also help. Dr. Holmquest is President and Chief Executive Officer of CalRHIO, a statewide initiative to make critical medical information available electronically at the point of care. Since joining CalRHIO in August 2006, he has led the organization in creating the
