Health Information Technology Policy

Public Sector Health Information Exchange: Challenges and Opportunities

National Governors Association State Alliance for eHealth

UMass Medical School’s Center for Health Policy and Research recently completed two HIT projects with the National Governors Association (NGA) State Alliance for e-Health, studying the challenges, opportunities, and governance issues related to public involvement in HIT and electronic HIE.

The NGA State Alliance for e-Health is a consensus-based, executive-level body of state elected and appointed officials charged to collectively review and address HIT and electronic HIE issues and challenges facing state governments. The group provides a nationwide forum for stakeholders to work together to identify interstate and intrastate HIT policies and best practices, and explore solutions to programmatic and legal issues related to HIE.

An Examination of the Public Financing, Accountability, and Oversight Models to Sustain Electronic Health Information Exchange (FAOS)
In collaboration the National Opinion Research Center, UMass Medical School’s Center for Health Law and Economics, and an advisory committee of electronic HIE, public utility, and economic experts

The Center for Health Policy and Research assessed the potential roles of state governments in overseeing and regulating the electronic HIE industry. The ultimate goal of this project was to provide governors and state government officials with a framework and a short list of potential electronic HIE governance models.  State governments in their roles as

• Purchasers of health care for Medicaid-covered individuals and state employees,
• Regulators of health care through policy setting, licensure, and enforcement of regulations, and
• Advocates of general public health, taking into account the dynamics of the health care marketplace in each individual state.

The final report presents the findings of a collaborative team of researchers on these topics:

• The current state of electronic HIE in the U.S. and the market issues that impact the sustainability of electronic HIE,
• The program and policy issues for state governments as they intersect with electronic HIE, recent government electronic HIE initiatives, and the coordination of state agency efforts,
• The oversight roles of state government and self-regulation in public utilities, finance, and other industries that are used to address inefficiencies of the marketplace in assuring both economic and social welfare,
• The attributes and defining features of a sustainable electronic HIE industry as identified through facilitated discussions with the Advisory Committee, and
• Three model institutional structures and arrangements by which states can provide accountable oversight to and support for a sustainable electronic HIE industry.

HIT and Electronic HIE in Public Programs: Opportunities and Challenges
In collaboration with the University of Southern Maine Muskie School of Public Service

The Center for Health Policy and Research provided research and academic support to the Health Information Communication and Data Exchange (HICDE) and Public Programs Implementation (PPI) Taskforces of the State Alliance for eHealth, analyzing the opportunities and challenges for publicly funded health care programs, as they leverage HIT and electronic HIE to improve health care quality, efficiency, and effectiveness.

The project team reviewed relevant literature, conducted 29 structured interviews with leadership from Medicaid agencies, state employee health benefits programs, and public health agencies, and facilitated discussions with the NGA HICDE Taskforce.  The HICDE Taskforce then used these findings to develop final recommendations for the State Alliance for eHealth in 2007 and 2008.

The PPI Taskforce convened in the spring of 2008 to further refine the recommendations of the HICDE Taskforce.  Center for Health Policy and Research staff supported the PPI taskforce by co-facilitating two meetings in 2008 and drafting the report to the State Alliance for eHealth.