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Governors’ Initiatives to Encourage Adoption of Health Technology Information Exchange

This article explores the efforts of governors to encourage the adoption of Health Technology Information Exchange (HIE) as a solution to the broken healthcare system. It discusses the goals, levers, and challenges faced by governors in this process.

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Governors’ Initiatives to Encourage Adoption of Health Technology Information Exchange

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  1. Governors’ Initiatives to Encourage Adoption of Health Technology Information Exchange John Thomasian Director, National Governors Association Center for Best Practices

  2. Why Governors Care About HIT • The health care system is broken • $1.7 billion industry. We spend twice as much as other industrialized countries and our results are half as much • Medicaid now consumes 23 % of state budgets, surpassing our investments in K-12 • The private sector is shifting health care coverage to the public sector when they can • Everyone else left in middle—45 million Americans uninsured

  3. System is Broken

  4. What is the fix? • Un-fragment a fragmented system • HIE is the backbone for overall health care reform. • HIE can tie records together, reduce unnecessary and redundant procedures, help improve quality, build basis for P4P, and reduce administrative costs

  5. Governors’ Goals for Health Care Reform • Deploy HIE and EMR to improve services and productivity • Improve quality of care, including disease prevention and management • Allow innovative financing strategies and rule changes to expand coverage • Empower consumer choice through price transparency, quality reporting, and financial incentives

  6. What are the Governors’ Levers? • The power to convene and bring disparate stakeholders to the table through task forces and other structures • Bully pulpit—sell it to the public and business • The regulatory lever • Incentives—tax codes, grants, reimbursement processes • State also is major market participant

  7. Who is doing What? • At least 30 states are moving forward in some manner to facilitate adoption of HIE • Most are setting up tasks forces and commissions to examine the issue and recommend next steps • A few—like Arizona and Florida—are establishing roadmaps for implementation, creating organizations to set standards, develop business practices, and forge linkages between networks • All are convening key groups of experts, providers, insurers, consumers, and other stakeholders

  8. The Challenges • Creating partnerships with and getting input from stakeholders • Agreeing on architecture • Creating standards and common exchange elements • Establishing governance • Solving security and privacy issues • Developing a business model and incentives for adoption

  9. Big Questions Remain • What business model or models make the most sense? • Big statewide private or public network? • Several big competing networks operating in parallel, sharing data? • Broker that strings together disparate, small networks • Financing—transaction fees, membership fees, or both? • Privacy—can we live with non-uniform, state-by-state system?

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