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Features
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Thursday, January 07, 2010
California Health IT Sphere in Flux in Wake of CalRHIO Shake-Up
---------------------------------------------------------------

by George Lauer, California Healthline Features Editor
CalRHIO, one of the country's first organizations designed to oversee
the exchange of digital health information, has been thrown into a
state of flux after failing to win designation as California's lead
health information technology agency. Leaders and employees have left.
Some of CalRHIO's board members may still be active in negotiations
with the state, but the future of the organization is unclear.

The upheaval at the California Regional Health Information
Organization leaves the recently reorganized California eHealth
Collaborative as the front-runner in the race to win the state's nod
to oversee billions of federal stimulus dollars for health IT
projects. The first wave of federal money -- about $40 million -- is
expected to begin flowing into California early this year. The
state-designated agency could end up disbursing billions of dollars
through a variety of federal programs over the next several years.
Last year, the state received seven responses to its invitation for
proposals from organizations interested in managing the state's health
information exchange. In December, Jonah Frohlich, California's
secretary of health IT, asked two finalists to amend their proposals
and collaborate on a joint plan. Frohlich, on Tuesday, said the two
organizations are still negotiating and he expects to see a joint
proposal from them in the next two weeks.

Frohlich declined to identify the two organizations, but according to
both CalRHIO and the CAeHC, they were the two finalists. A message on
CalRHIO's Web site says negotiations broke down and that a report was
made to state officials saying "the parties were unable to reach an
agreement."
Letter to Stakeholders

The undated two-page "Letter to All California Stakeholders from the
CalRHIO Board of Directors," says in part:
"Earlier this year federal legislation was passed to provide funding
for states to establish health information exchanges under the
American Recovery and Reinvestment Act (ARRA). CalRHIO participated in
California's RFI process to be designated as the governance entity for
HIE, including state-directed negotiations with the California eHealth
Collaborative (CAeHC) in an effort to form a new governance entity.
CalRHIO reported to the state last week that the parties were unable
to reach an agreement."

Attempts to get comments from CalRHIO officials were unsuccessful. The
organization's voicemail system is full and cannot accept new
messages.
A statement from CalRHIO CEO Molly Coye in the letter indicates that
individuals from CalRHIO's board of directors or management team might
still be participating in discussions with the state and California
eHealth Collaborative, but so far, nobody's talking.

In the letter, Coye wrote, "We are pleased that key leaders from the
CalRHIO Board will play a significant role in the new governance
entity."
In an e-mail, Donald Crane, a CalRHIO board member and CEO of the
California Association of Physician Groups, said he was unable to
comment because of "confidentiality restrictions." Crane is reportedly
one of CalRHIO's representatives still involved in negotiations.

Some reports have Crane and David Lansky, CAeHC board member and
president/CEO of the Pacific Business Group on Health, becoming
co-chairs of the soon-to-be-created entity.
CalRHIO Effectively Disbanded

Several sources in California's health IT community acknowledged this
week that CalRHIO has effectively shut down.
In an e-mail to friends and colleagues last week, Coye wrote:

"Building on five years of solid work, CalRHIO delivered a strong plan
for HIE governance and deployment, with private capital to leverage
the new federal funds available from the HITECH Act and finance the
full costs of building out HIE connectivity in California. In the end,
however, the state of California decided to form a new governing
entity for the statewide HIE initiative. CalRHIO has pledged our
support for the state's efforts and for the formation of the new
organization.
"As a result, I will be taking the next four months to engage in a
variety of activities, starting with some time off and then providing
support for several federal and private advisory groups."

If CalRHIO is still involved in negotiations, it is in name (and
perhaps selected board members) only, according to several sources.
The organization has effectively disbanded, and the handful of
employees are in the process of moving on, sources said.
CalRHIO was formed in 2005 when Gov. Arnold Schwarzenegger (R)
convened a summit and called for the creation of a statewide
organization to help the state's health care system move into the
digital age. CalRHIO was formed as a public-private entity
encompassing health care providers, payers, patients, insurers,
government agencies and consumer organizations with two main goals:
investment in IT and the secure exchange of information using that
technology.

New Leadership for eHealth Collaborative
Last fall, after officially entering the race to become the state's
designated information exchange organization, CAeHC (pronounced
"cake") reorganized with new board members and new management. The new
CEO of "CAeHC 2.0" is Michele Kang, former vice president and general
manager of Northrop Grumman Information Technology's Health Solutions
division.

Kang said CAeHC will issue an announcement Friday. The three-page
announcement says, in part:
"We wish to express our gratitude to CalRHIO, led by Molly Coye, MD,
for the devotion to pursuing a vision for improvements towards the use
of health information technology. Molly's leadership and convening of
stakeholders played a strong role in creating focus on important
issues such as privacy and security, technical architecture,
governance and business sustainability in California.

"We also thank the board members of CalRHIO for their leadership and
the staff of CalRHIO for providing the groundwork for which the
stakeholders may move forward in advancing the principles for which
CalRHIO was founded.”
Next Steps

State officials expect to see a final proposal in the next two weeks.
"Our internal committee would have to review that proposal," Frohlich
said. "And I would hope we'd be able to make an announcement shortly
after that."

Frohlich said the new entity will be a private organization, not a
part of state government.
MORE ON THE WEB

CalRHIO's letter to stakeholders
CAeHC's reorganization announcement

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RELATED STORIES
---------------

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12/10/2009
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