Tenn. winds down state health info exchange in favor of Direct

The Health Information Partnership for Tennessee, the state's federally funded, statewide health information exchange organization, has started "winding down" its operations, a state official confirmed.

Instead of running a statewide exchange, Tennessee will focus its efforts on promoting the use of the federally developed Direct exchange protocol for peer-to-peer messaging, according to Will Rice, executive director of the Office of eHealth Initiatives, the state agency that coordinated the formation of the not-for-profit HIP TN in 2009.

The new state aim, Rice said, is to ensure that Tennessee providers meet expected information-exchange goals of the Stage 2 meaningful-use criteria of the electronic health-record incentive payment program funded by the American Recovery and Reinvestment Act of 2009.

"I think sustainability for HIE services has always been an Achilles' heel for those organizations," said Rice, adding that the HIP TN board approved the closure, feeling statewide exchange "was ahead of the game and somewhat premature."

"With a shift in strategy to meet the demands of meaningful use, while the state is not abandoning its effort of statewide HIE capacity, that's a longer-term horizon than what's needed to meet meaningful use," Rice said.

Tennessee has four of five community-based regional exchanges in operation, in pilot-test mode or in planning stages, Rice said. The long-term goal will be to connect those that survive, with an eye toward statewide exchange capabilities.

In the meantime, however, state efforts will be to "showcase Direct and broaden the education and awareness around Direct," he said.

As part of that campaign, the state is already working on a way to either formally certify or less formally recommend accreditors of Direct functionality to Tennessee providers.

So far, the state retains unspent more than 70% of the nearly $11.7 million in stimulus-law funds it received under the State Health Information Exchange Cooperative Agreement Program administered by the Office of the National Coordinator for Health Information Technology at HHS. Rice said he was confident there was enough money left for its Direct promotional campaign.

And although HIP TN never reached the point where it handled the exchange of healthcare information in a production environment, there was some "system-level testing between communities" as well as a demonstration of information being submitted to public health registries. "There are many advances we can take away from the HIP TN experience," Rice said.