Twelve states are out in front when it comes to adopting health information technology in their statewide Medicaid programs and another two dozen are close behind, according to a just-released government report. But the level of progress and the types of technologies in use vary widely, and no state has implemented a personal health record initiative, the report also shows.
HHS Office of Inspector General found that 12 state Medicaid agencies have implemented a total of 16 health IT initiativesincluding claims-based electronic health records, e-prescribing and remote disease monitoringfor their Medicaid populations.
The report also found that 25 state agencies are involved in the planning and development of statewide health-information-exchange networks.
"We are committed to working closely with our many stakeholders to ensure prudent implementation of HIT in a manner that detects and prevents fraud, waste and abuse in the Medicare and Medicaid programs," Inspector General Daniel Levinson said in a written statement.
The states' efforts dovetail with a long-range plan, championed by President Bush, to have electronic health records widely available in the U.S. by 2014. On the heels of that goal, HHS Secretary Mike Leavitt has said that he wants Medicare and Medicaid to lead in the effort, in part as a way to improve care, but also as a tool to control spiraling costs. In fiscal 2005, federal and state costs in the Medicaid program reached $317 billion, according to the inspector generals report.
The twelve states are: Florida, Iowa, Kansas, Louisiana, Mississippi, Missouri, Montana, Pennsylvania, Tennessee, Vermont, Wisconsin and Wyoming.
But obstacles to the development of fully functional EHRs continue to dog state Medicaid directors, especially when it comes to keeping those records secure and private, and could end up stretching the presidents timeline. "When you are breaking new ground, there is no cookbook for privacy and security issues," one director is quoted in the report as saying. "Our lesson learned is that everything is more complex than you think it will be."
Based on the findings of the study, the inspector general's office said that CMS should continue to work with states and other federal agencies to help accelerate the adoption of health IT.
David Merritt, a project director for the consultancies Center for Health Transformation and the Gingrich Group, said that state health IT efforts have outpaced those by the federal government.
"The most important recommendation in the report is urging HHS to continue to work with states as they move ahead," Merritt said. "All too often, HHS and leaders in the states work in isolation. There are exciting things going on across the country, and Washington should learn from these innovations and support them as much as possible."
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