Today, we released a case study from the evaluation of the HITECH-funded State Health Information Exchange (HIE) Program that shows how states play a central role in leadership, coordination, collaboration, policy development, and identifying local health IT needs and gaps.
At ONC, we are undertaking important work – along with our federal partners and private-sector stakeholders – to advance the collection, sharing, and use of interoperable information. Notably, the Federal Health IT Strategic Plan 2015-2020 released earlier this month and the Nationwide Interoperability Roadmap set for release in early 2015, sets course for how the federal government and private sector can facilitate the seamless sharing of health information among trusted entities. As we move forward with these endeavors, it is important to reflect on our previous efforts, and highlight lessons that can inform and guide future activities.
NORC at the University of Chicago is currently conducting a multi-year program evaluation of the State HIE Program to characterize states’ approaches to enable HIE, assess their progress, and identify key lessons for overcoming challenges. The case study synthesizes more than 100 interviews with a variety of stakeholders to examine the experiences of six grantees: Iowa, Mississippi, New Hampshire, Utah, Vermont, and Wyoming.
Given the differences among the states targeted in the study in regards to geography, population size, presence of large health systems, and prior experience with supporting HIE, it is not a surprise that context was a major factor in how these grantees organized and operationalized their respective programs. Technical approaches, services enabled, and the use of policy and legislative levers varied across the grantees. Although this finding may appear self-evident, accounting for local context is critical when designing technical, behavioral, or policy solutions to advance interoperable HIE.
Put another way, what works for Iowa may not work for New Hampshire.
A second key finding from this case study is the need to set tangible and achievable intermediate goals that keep stakeholders energized by ongoing progress and success. In an environment where technology and supporting infrastructure continue to evolve, it is important to define incremental processes and goals that promote dexterity and support strategy adjustments and refinements. In some states, they migrated from relying on a single HIE developer to a best-in-class approach, working with multiple HIE developers to address different needs and gaps.
Another takeaway from this effort is the importance of collaboration and support among key HIE participants. As part of this program, grantees worked with a diverse set of stakeholders, including hospitals, large provider organizations, small provider offices, the public health community, electronic health record and HIE developers, state Medicaid offices, pharmacies, payers, consumer advocates, and clinical labs. States play a critical role in convening these stakeholders, identifying common needs, establishing trust, developing governance mechanisms, and fostering collaboration. NORC found that the more parties that supported, promoted, and participated in HIE, the …read more