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State and Federal HIT Efforts

February 3, 2010
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David Raths reports from the National Government Health IT Summit in Washington.

by David Raths

A pair of interesting talks about state and federal health IT efforts led off the Feb. 3 National Government Health IT Summit in Washington, D.C.

A presentation, by Alan Weil, executive director of the National Academy for State Health Policy, served to remind people who work in health IT to keep their eye on the programmatic priorities of state government health agency leaders. From a 2009 survey of state health policy leaders, Weil summarized their five main goals:

  • Connect people to needed services
  • Promote coordination and integration in the health system
  • Improve care for populations with complex needs
  • Orient the health system toward results
  • Increase health system efficiencies.

He described one example of how health IT could help in improving care for populations with complex needs: approximately 40 percent of the people on Medicaid are “dual-eligible” with Medicare. One negative side-effect of Medicare Part D is that now people in nursing homes on Medicaid get prescription drugs through Medicare. Those systems, one state-run and the other federal, don’t readily share data, so providers don’t get a single view of those patients’ care. Health IT solutions could eliminate silos between those (and other) systems to improve that information flow.

Vendors, consultants and federal officials also must understand that working in state health agencies “is pretty miserable right now,” Weil said. For example, one of the greatest challenges he has in planning meetings with state officials is working around all the people on furlough. States do not have the capacity to do everything they’d like to do in updating antiquated legacy systems, so they must take their top few priorities and build an infrastructure to support them. The HITECH Act has created an imbalance, Weil said, where beleaguered officials see the health IT funding as their salvation. “But that’s the tail wagging the dog,” he said. “It’s an underfed dog, and that tail is pretty big.” States must pull back from the allure of all that money and do the hard thinking about health system improvements.

The bottom line, Weil said, is that any health IT strategic plan has to derive its goals from specific tasks agencies have identified, rather than working to create a broad health IT infrastructure for its own sake and then applying it.

In an earlier presentation, an enthusiastic Todd Park, chief technology officer of the Department of Health and Human Services, talked about some ways that he is trying to get HHS to look at its own data in new ways.

Park, who co-founded athenaHealth, is pushing HHS to do “smart targeting” to apply the type of analytics that national intelligence agencies use across HHS agencies, looking at structured and unstructured data, to elucidate patterns in healthcare delivery and outcomes. He also talked about harnessing the power of social networking and Web 2.0 technology to share best practices. Park gave an example of a food safety widget that can feed safety alerts over Twitter, but said that is just a beginning. He said he is “working startup hours again” to make HHS a catalyst to leverage the power of data and networking to build collaboration across communities.

Both Aneesh Chopra, U.S. chief technology officer, and David Blumenthal, MD, national coordinator for health information technology, are scheduled to address the conference on Feb. 4.