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Has Your State Designated an Entity to Coordinate HIE?

August 11, 2009
by David Raths
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How ready is the government in your state to take the reins in overseeing health IT efforts there? Are your governor and state CIO engaged? Is there already a healthy ecosystem of public and private players working out health IT policy details?

Lynn Dierker, RN, project director for the State-Level HIE Consensus Project, has noted that when it comes to HIE sophistication, states basically fall into "three buckets." One group is advanced and implementation-ready. Another group is almost there, but may need to revise its strategy on planning and deployments in the wake of the HITECH Act. A third group is really scrambling right now because they have no established governance and it isn't clear who is going to deal with funding, including applying for and managing grant funds. An important part of that task will be establishing accountability measures for the health IT strategy.

Last week I wrote about a study on how health information exchange lessons learned in Europe might inform U.S. efforts. I noted that the big differences in attitude about the role of the federal government in healthcare would have an impact on how HIEs are adopted here.

Some of the same questions about what role the government should play also are being asked at the state level. As states prepare to handle their share of stimulus money to work on interoperable EHRs, many are undergoing internal debates about whether a department of the state government should oversee the implementation of health IT efforts or whether a nonprofit, public-private partnership should be given a contract to tackle the job.

Cleary the implementation of the HITECH Act will expand the role of state government, including managing the Medicaid incentive payments. Currently nine state governments host state-level HIE efforts from within state government. But from their own experience, many State-Level HIE Consensus Project participants perceive that it would be better for a state-level HIE entity to be a structure that sits outside of state government, so it won't be subject to the same financial turmoil state governments are facing, and won't have to follow the same stringent procurement rules.

A good example of a public-private partnership would be the New York eHealth Collaborative (NYeC), which is facilitating a statewide collaboration process involving the New York State Department of Health, RHIOs that have received state contracts, and other stakeholders.

Later this week I will interview Laura Landry, executive director of the Long Beach Network for Health, about California's particular challenges and the California eHealth Collaborative's recommendations for its health IT planning process. Hey, if we can get California right, that's about 10 percent of the country's HIE issues solved right there!

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