Feds Might Want to Take a Page from State Approach to HIT Adoption by Laura Kolkman

(February 4, 2009) Efforts on Capitol Hill by HIMSS and the Electronic Health Records Association are paying off, as evidenced by the $20 billion allotted to healthcare IT in the House version of the economic stimulus bill. It also included policy changes that could result in $30 billion in net bonuses for providers who implement and use certified HIT products over the next decade.

HIMSS continues to lobby hard to ensure the Senate’s version of the stimulus bill includes the same level of support for HIT – support that will ultimately serve to accelerate the efforts already underway at the federal and state levels. In fact, when it comes to spending those HIT dollars, the federal government would do well to study accomplishments in numerous states.

States have successfully addressed many of the key policy concerns regarding electronic health information, including interoperability, privacy and security and alignment of costs and benefits across stakeholder groups. Aggressively tackling these key policy issues has allowed many states to achieve HIT adoption at an impressive pace, while at the same time helping to advance federal initiatives, including the nationwide health information network (NHIN).

For example, in January,Kentucky announced plans to create a statewide HIE as part of its strategy to become a “test bed” for ascertaining HIT’s value to the public. The state has issued an RFP for infrastructure development, which it expects to award later this month. The winning vendor will be required to provide EMRs for physicians, connections to Kentucky Medicaid and private payers, and access for researchers to relevant data within the HIE.  The goal is for the first information exchange to begin early next year.

In Indiana, state leaders are encouraging Congress to consider that state’s HIE platform as the model for the rest of the nation when deciding how best to invest the monies earmarked for HIT in the stimulus bill. Considering the tangible value the state has derived from the HIE platform, it’s not just boasting.

Created by the Regenstrief Institute and operated by the Indiana Health Information Exchange (IHIE), the Indiana HIE connects 39 hospitals, 10,000 physicians and more than 6 million patients. It allows for the secure, near real-time delivery of lab results, reports, medication histories and treatment histories. The system also provides statewide preventive health and chronic disease management. A free service recently launched by IHIE also allows providers to integrate reminders and alerts about their patients who are due for preventive screenings and chronic disease follow-up care.

Finally, in mid-January, eight states began piloting the Health Information Security & Privacy Collaboration Provider Education Toolkit, developed as part of a federal initiative that encourages provider participation in electronic health information exchange technology by providing information about privacy and security.

The Toolkit, found at www.secure4health.org, is being piloted by Mississippi, Florida, Kentucky, Louisiana, Michigan, Missouri, Tennessee and Wyoming. It provides physician-to-physician advice, resource links and answers to frequently asked questions. Information is focused on HIE and related privacy and security implications, as well as the tools and resources to help providers get connected electronically.

These are just some of the most recent examples of the proactive steps that states are taking to accelerate adoption and maximize the value of HIE for the nation as a whole. By understanding and cherry picking the most successful aspects of HIE at the state level, the federal government will have a solid framework to guide the investment of funds appropriated for HIT and accelerate the NHIN.

More than any time in the past, this is an opportunity to bring the unquestioned benefits of full HIT and HIE adoption to fruition.  By having the processes and tools in place to allow widespread and ready access to health information, we can radically -- and very positively -- improve the overall quality of health care delivery in this country.  It is something we should all, regardless of our role or position in the nation’s healthcare system, be actively championing.

Laura Kolkman is President of Mosaica Partners (www.mosaicapartners.com), a nationally recognized HIE consulting firm, and Chair of the HIMSS HIE Steering Committee.