Are there really two thousand and ten state HIT initiatives?

By Jeff Rowe, Editor (original article found here)

Needless to say, the answer to the above question is “No”, but an interesting graphic choice on the title page of a recent report from the National Association of State Chief Information Officers (NASCIO) unwittingly makes a good point.

In short, state HIT efforts currently underway across the country come in many shapes and sizes, and, as this blurb puts it, “it can be overwhelming to encapsulate how these ventures are related and what people and organizations are in charge of them.”

Making sense of the state-by-state array of ventures is the goal of the 2010 State Health IT Initiatives, the fourth such compendium that “outlines where state health IT initiatives stand and draws attention to the role of the state CIO in these efforts.”

From Alabama to Wyoming, readers are provided with a snapshot of how each state is approaching HIE development. As the report’s introduction points out, “ A statewide HIEs key objective is to provide an enterprise-wide architecture that will be secure, efficient, and interoperable for the exchange of information amongst all stakeholders. The state CIOs recognize that there is no better opportunity than now for carrying out these goals.”

Those goals, however, are where much of the similarity ends between the programs, for as quickly becomes clear there are apparently, well, at least 50 different approaches to structuring an effective HIE.




Alabama’s HIE, for example, has a 23-member governing Commission and includes the involvement of several state agencies. In Iowa, on the other hand, a 9-member Executive Committee calls the shots and the operation is housed entirely within the Iowa Department of Public Health.






It seems reasonable to suggest that, at some point, a certain level of uniformity will help tie the HIEs together, but for the time being the states are clearly focusing on figuring out what works for their own healthcare sectors.






We’ve referred before to Supreme Court Justice Louis Brandeis’ vision, articulated in a speech in 1932, of the states as “laboratories of democracy.” When it comes to building HIEs, the 2010 NASCIO report gives readers a good look at how those laboratories are doing.