Consumers (ie, patients) are very aware of problems obtaining their medical records, and also having repeated testing when changing physicians.  They recognize the inefficiencies of our health system and thier attendant costs.  Consumers can and will begin to play an increasing role in their own healthcare and begin to place further demands on physicians, providers and their insurance payors. There are many health related consumer advocacy organizations that have grown up in the past decade.

The internet has further expanded this role.  Those interested in RHIO development and the pursuit of EMR should involve their patient base to influence congressional activity.

I however feel this networking will take place best in the atmosphere of private development.  Social planning and direction is necessary overall to pave the way and give direction to the effort. 

Providers have it in their power to demand from payors suitable contracts that require  payor participation in financing these networks that payors derive so much benefit from leaving the hard grunt work to the provider.  Every provider on his next round of contract renegotiation and/or amendments should place this demand on the payor(s).

This "new idea" of grass roots activity seems to be a new one when I discuss it amongst my colleagues. It however has been very well accepted.  Rather than leaving it to our larger organizations such as the AMA or state organizations to negotiate terms with payors providers themselves have  enormous bargaining power.

Why should I as the provider spend late nights performing paper work tasks at my expense for the insurance  company to justify my charges, when at the same time the payors reduce my payments, and demand studies of outcomes, and pay for performance.???

Our RHIOs and EMRs must be funded by all those who gain from their use, not just the provider.