“A Lap Band is a silicone belt wrapped around the stomach to control hunger and feel full. ”

“A breast augmentation involves the surgical insertion of an implant to create the illusion of larger or more fuller breasts. ”

“Cataract surgery will significantly improve the patient’s life by gaining clear eyesight by the removal of the clouded lens of the eye.”

CalRHIO is in a catch-22 situation, because if it doesn’t include data from local competitors, then odds are your patient’s data is not in the system, in which case it has no value, and if they do include local competitors then you have the same issues other RHIOs face. CalRHIO can’t get around that – if it includes local data there will be competition, and if it doesn’t I’m not going to pay to access it.

If the payors paid for it, which they should because they’re the only ones who benefit financially from a RHIO (other than the patients, who nobody will ask to pay), then it might fly, but it’s got a tough road without that because nobody else can see the value to justify the cost. Indiana’s business model doesn’t really work outside of the local area, and it’s the only model that’s been shown to succeed. There’s good reasons these systems generally fail, and it goes back to the US payment model, but that’s a whole other story…

Value of Health Information Exchange (HIE) in Ambulatory Care:
http://healthit.ahrq.gov/portal/server.pt?open=512&objID=654&PageID=11997&mode=2&cached=false&sp=true&pubURL=http://prodportallb.ahrq.gov:7087/publishedcontent/publish/communities/a_e/ahrq_funded_projects/projects/value_of_hie_in_ambulatory_care.html&gn=1R01HS015409-01

An Evolving State-wide Indiana Information Infrastructure: http://healthit.ahrq.gov/portal/server.pt?open=512&objID=654&PageID=11997&mode=2&cached=false&sp=true&pubURL=http://prodportallb.ahrq.gov:7087/publishedcontent/publish/communities/a_e/ahrq_funded_projects/projects/evolving_state_wide_indiana_information_infrastructure.html&gn=290-04-0015

I would be shocked if they don’t have at least several major plans signed up by next year including a few of the big nationals and a couple of prominent Blues.

My bigger interest though is if Brailer is going to be so conservative in general with his investing strategy or if he just really doesn’t much out there that he thinks is worthwhile right now. My bet is a combination of the two.