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The Importance of State-Based Advocacy for Health IT

March 13, 2009
by Rich Temple
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We have, as an industry, a once-in-a-generation chance to be able to “change the game” as far as health IT is concerned. The recently-enacted HITECH legislation (known more formally as the “Health Information Technology for Economic and Clinical Health Act”, signed into law by President Barack Obama as part of the “American Recovery and Reinvestment Act of 2009” offers unprecedented opportunities and funding for those opportunities, and we as an industry have to do everything we can to make sure these funds are spent optimally and this opportunity is not squandered with money going down a bureaucratic sinkhole.

As we dive into the legislation, we discover that many of the real potential opportunities for the transformation we have long been seeking lie at the State level. Health information exchange projects are a big piece of this and, in order to take advantage of these, there needs to be State matching funds, the ratio of which will increase as we move further into the future. The HITECH legislation also provides for state-level revolving loan funds to facilitate EHR adoption by a wide array of providers. Furthermore, the legislation establishes “Health IT Regional Extension Centers” which are anticipated to take the lead in providing technical assistance at the local level for a multitude of potential health IT projects.

I don’t think I am going too far out on a limb here to posit that State legislators are, for the most part, not optimally attuned to the best way to turn this money into real benefit for caregivers and society as a whole. They may want to, but without guidance from leaders on our side, monies can be expended on things that are perhaps, at the very least, ill-advised or, at the very most, destructive to our goal of bringing technology to bear on a grand scale to save lives and improve patient outcomes. This isn’t a result of malice or worse on anyone’s part; it is just that the people who are charged with disbursing the funds don’t live and breathe in the world that those funds are designed to benefit.

We as health IT professionals DO live in that world. We need to make sure our voices are heard in our State legislatures and that we position ourselves as subject matter experts on the world of health IT. This won’t be resisted at all by the legislators – rather, it will be welcomed, as they have an awful lot of their plate and they would like nothing more than to have reliable sources of information that they can call upon. We need to be highest on that list of “reliable sources” as it relates to health care in our respective states. We need to articulate the vision loud and clear (once we have finalized it in our own heads) and paint an easy-to-understand picture for our governmental leaders the benefits, not only to society, but to the State coffers, through better coordination and less erroneous payments or unnecessary payments for duplicative services. It will be a very, very long time – if ever – before we have another chance like this; we cannot blow this!

In New Jersey, we held a very successful legislative Advocacy Day this past Monday. Over 100 leaders from health care from across the State gathered to share their vision with State legislators and begin to build those relationships. You can more about that day here, in Kate Huvane Gamble’s blog on this site, and how we were able to pull off an event of this magnitude. This is just the beginning, though, we need to build on this and keep in front of those who will be charged with administering the HITECH funds at the State level because this is where we can make a profound difference!



Rich - Great article and David - Great links. We're got a lot of educating to do, but at least we're on the radar!

Most certainly, I would enthusiastically recommend that. The local chapters of HIMSS are right on top of all this and can and should be a valuable resource for all interested parties.

In New Jersey, please feel free to contact Neal Ganguly, the President of NJ HIMSS at


Excellent post, Rich.

I agree completely with your point that "many of the real potential opportunities for the transformation we have long been seeking lie at the State level." If you need evidence of that, look at what's being done in Massachusetts.

I also believe that state leaders, in most cases, definitely do want to use funds to help healthcare providers, but that they need guidance on how this can be achieved. If legislators are willing to listen, I think it's absolutely critical for those in the field to take the time to educate them, as so many did in NJ on Monday.

If people want more information on this, should we recommend contacting their local HIMSS chapter?


Rich, thanks to you and all the HIT professionals who made it to the state capito for Advocacy Dayl. You are all really fighting the good fight.

I too appreciate Rich's post about the need for education and advocacy at the state level. As I discovered when researching a story about state-level policy activity last October, there are quite a few efforts to help states share best practices so they are not re-inventing the wheel:

· The National Conference of State Legislatures' Project Health Information Technology Champions is a public-private partnership to educate legislators on the new complexities of health IT. Besides bringing interested legislators together for regular meetings, Project Hitch also tracks legislation and executive orders and makes summaries available in a searchable database.

· The National Governors Association State Alliance for eHealth was created as a state counterpoint to the federal American Health Information Community (AHIC) to involve governors, legislators, insurance commissioners and public health officials. Its task forces work on issues such as how state Medicaid programs can get involved in HIEs and how states' regulatory environments can promote the use of telemedicine.

· The American Health Information Management Association's State Level Health Information Exchange Consensus Project was launched in 2006 to bring together the people running HIEs.