There have been various terms used to describe what is simply the exchange of patient data between different entities. RHIO and HIE are two terms often used, with HIE being the one most used today.
What is HIE or Health Information Exchange?
eHealth Initiative defines it in the most simple terms:
The act of transferring health information electronically between two or more entities.
The Markle Foundation uses the Wikipedia definition of HIE:
HIE is defined as the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move health care information between various systems while maintaining the meaning of the information being exchanged. In other words it is the set of technologies that brings all the personal health information required to make safer, more informed decisions at the point of care.
So, how do an HIE and RHIO compare? In April 2008, the Office of the National Coordinator for Health Information Technology (ONC) issued a report entitled “Defining Key Health Information Technology Terms.” This report defined RHIO as:
A health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community.
In its most basis sense then, a RHIO covers a specific geographic area while an HIE may connect the different geographies together.
AHIMA delivers a good overview of RHIOs and HIEs - Understanding the HIE Landscape.
Another term used in conjunction with HIE is NIHN – Nationwide Health Information Network. The ONC defines NIHN as:
The nationwide health information network is a set of standards, services and policies that enable secure health information exchange over the Internet. The network will provide a foundation for the exchange of health information across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act.
These terms provide some navigation capability through the world of HIEs. To put this all in context, the best way is by ending on a quote from the ONC director – David Blumenthal, M.D., M.P.P.:
“Ultimately, simple exchange will be part of a package of broader functions that allows any provider, and ultimately consumers, to exchange information over the internet, enabled by NHIN standards, services and policies.”
“As we head into the next stage in the development of nationwide HIE, we should all take a moment to reflect on how far we have come and evaluate our plans for the future. We have done a great deal of work in the short period of time since the passage of the HITECH Act. We appreciate your willingness to stay engaged and involved in every step of our journey, and we look forward to our continuing collaboration to improve the health and well-being of our nation” (CMIO, Blumenthal: NHIN ‘natural evolution’ will support HIE reform, May 14, 2010).

