Garber pointed out that it's a one-time cost of $2,000 for small healthcare organizations and approximately $15,000 for large organizations that have a lot of data. The only ongoing cost is the maintenance, which he estimated at $500 per year, or 20 percent to 25 percent of the upfront cost.

"RHIOs have so many layers and spent a ton of money," he said. His philosophy is that the most important thing is to make the connection between the healthcare organizations.

"There's no need to formalize a RHIO," he said. "This is a low-cost, simple, elegant model."

The SAFEHealth architecture is legally simpler and lowers the cost. Fallon Clinic already has an Enterprise Master Patient Index (EMPI) that it monitors, so it acts as the trusted authority to host the EMPI, which eliminates the cost of maintenance for participating healthcare organizations. IAn estimated 1 million patients are preloaded in the EMPI.

Contrary to the community health information networks of the 1980s and HIEs and RHIOs that are struggling to become sustainable, this model delivers financial value to all stakeholders, said Richard Mohnk, the CIO of HealthAlliance Hospital.

A large number of Fallon Clinic's managed care patients end up at HealthAlliance's ED, he said. By being able to share information such as a medication list and clinical history, ED doctors can provide better care for the patients. Not only do the health plans of the patients benefit, with fewer tests being ordered, but HealthAlliance and Fallon Clinic build a strong relationship that will result in more patient referrals, Mohnk said.

HealthAlliance is a member of the UMass Memorial Health Care system. Fallon Clinic hopes to expand to all hospitals in the system and throughout central Massachusetts, said Garber. At some point the CONNECT, a software gateway that connects health IT systems to HIEs using the NHIN standards, may be added "when appropriate" to be a "node in the NHIN network," he said.

While it's too early to glean any statistics on improved clinical outcomes, Slayton and Garber recalled one ED doctor's response when all of the patient's relevant data popped up on the screen: "Sweet!"