What is a health information organization?

The process of HIE requires a formal degree of oversight to facilitate and govern the exchange of health-related information between organizations. The first incarnation of this oversight function to emerge from the marketplace was the regional health information organization or RHIO. But as different business and technological arrangements came into being to foster exchange of health-related information, they did not fit well into the confines of a RHIO as it was becoming defined by such characteristics as geography and community-based governance. To effectively account for and describe the range of possible organizational types, a term to uniquely define oversight organizations is necessary. The term HIO affords an opportunity to be as general or specific as desired when referring to the arrangements governing the exchange of health information and identifying the nature of participation. As one result of this approach, the term RHIO can be placed in its proper perspective and defined distinctly. Thus a RHIO is positioned in this report as a type of HIO with a well-defined purpose and participation, one among many other potential types of HIOs with different purposes, participants and contractual agreements. Examples of other types of HIOs include health data banks, specialty care organizations, and integrated delivery networks (IDNs). Other types of HIO organizations can, if desired, differentiate themselves by substituting another defining word and acronymic letter ahead of the root term HIO.

Health Information Organization (HIO) An organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards.

Understanding an HIO

The purpose of an HIO is to perform oversight and governance functions for HIE. Oversight functions of an HIO may include, but are not limited to:

•  Facilitation of operations associated with the movement of information—assuring that hardware, software, protocols, standards, stakeholders and services supporting the interoperable exchange of health-related information are available and engaged.

•  Fiduciary responsibility for the assets, accountability for abiding by regulatory requirements for handling personal health information, and adherence to standards enabling interoperable information exchange.

•    Maintenance of information sharing agreements, business associate agreements, or other such contracts. 
•  Adoption and maintenance of standards ensuring interoperability while protecting the confidentiality and security of the information. 
•  Making decisions regarding certain types of information for which no nationally recognized interoperability standard is available.
•   Developing and sharing best practices among organizations. 

Although an HIO is identified as the organization overseeing HIE among disparate entities, HIE can also be implemented within a single organizational structure--for example, an integrated health care delivery system that converts from a proprietary, non-standard information exchange architecture to HIE architecture using nationally recognized standards. The health car benefits by being in a position to exchange health-related information with other HIOs as they develop and mature system.