Another indication that states—and not regions—may be the cornerstones of health information exchange is that so many state information technology officers are already involved in building exchanges within their jurisdictions, according to a professional association of state government IT officials.
The National Association of State Chief Information Officers, or NASCIO, in a recent report, “
Profiles of Progress III: State Health IT Initiatives,” concluded that more than half of state CIOs “were involved at some level with state-driven health IT initiatives … even though financial resources were often uncertain at best.”
The game has changed since the American Recovery and Reinvestment Act of 2009 was passed in February, according to the Lexington, Ky.-based association. The stimulus law provides an estimated $34 billion through Medicare and Medicaid for electronic health-record subsidies for office-based physicians and hospitals. It also appropriated $2 billion for use by HHS' Office of the National Coordinator for Health Information Technology to fund grants to promote IT adoption and information exchange.
Last week, Vice President Joe Biden
announced HHS had allocated nearly 58% of those appropriated funds. Earlier, HHS reported $589 million had been set aside to establish and run regional health IT extension centers to help hospitals and clinics implement EHR systems and use them according to best practices and another $564 million to develop health information exchanges.
Also this month, the HHS-funded
State Alliance for e-Health opined in a 32-page report that, because of the stimulus law, states would take the lead in developing and providing structure and legal oversight of health information exchange, including helping set privacy and security policy.
The NASCIO, which represents chief information officers, IT executives and managers from the states, U.S. territories and the District of Columbia, concurs with that assessment. The association said in its report that “privacy and security have consistently been a top priority for state CIOs” but as a proposed national health information network connects to state Medicaid IT systems, “state CIOs will likely play a larger role going forward in ensuring EHR privacy and security in regards to the transmission of data throughout their enterprise,” the report said.
One specific challenge for state-level IT leaders is implementing the Medicaid IT Architecture, or MITA, a national model to guide states as they develop and improve their Medicaid IT infrastructure.
“In order for states to begin down the path of MITA maturity,” the report said, “they first must conduct a state self-assessment” that includes identifying where states are now in their IT programs as well as their goals for a future state of IT development. The healthcare IT provision of the stimulus law “opens the opportunity for the MITA road map and business reference model to be applied to areas beyond just Medicaid systems,” the report said. The stimulus law also requires states to assess their future IT goals to be eligible for federal grants to develop healthcare IT exchange, the report said.
“State CIOs would benefit greatly from reaching out to the appropriate people to gauge where their state is in the MITA adoption and implementation process and strategic plan,” the report said.
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