Health nets grow up fast

When Congress returns from its August recess, it will tackle the questions raised by legislation aimed to improve the American health care system through information technology. Administration policy-makers also will begin a new wave of policy and strategy considerations under the official structure of the Office of the National Coordinator for Health IT.

The eHealth Initiative Foundation has released a landmark report, "Emerging Trends and Issues in Health Information Exchange." The report offers some findings from the eHealth Initiative's 2005 survey of state, regional and community-based health information exchange initiatives and organizations. It takes the pulse of 109 regional, state and community initiatives to measure their progress, challenges, organization and technical structures.

The report is beneficial to those seeking on-the-ground insight from experienced professionals in health information exchange. It is also an eye-opening overview of challenges faced by these efforts, from those that are just getting off the ground to those that are already exchanging information.

The study of multistakeholder efforts representing initiatives in 45 states and Washington, D.C., demonstrates that efforts are rapidly advancing through the steps necessary to electronically exchange health information to improve health care quality and safety and health care savings while preserving the security of individual health care information.

We found that 44 health information exchange initiatives are in the early stages of development, while 65 are in the advanced stages. Among those that are advanced, 25 are already operational, compared to just nine identified as operational in our 2004 survey.

Other key findings highlighted in the report include:

• The main driver moving states, regions and communities toward health information exchange is perceived provider inefficiencies, with rising health care costs also seen as an important driver.
• Health information exchange efforts recognize the importance of privacy and security.
• Health information exchange efforts are maturing: Organization and governance structures are shifting toward multistakeholder models with the involvement of providers, purchasers and payers.
• Advancements in functionality support improvements in quality and safety.
• Health information exchanges deliver more information and use standards for data delivery.
• Securing funding to support start-up costs and ongoing operations is still recognized as the greatest challenge for health information exchange efforts; engaging health plans and accurately linking patient data are also seen as challenges.
• Funding sources for upfront and ongoing operational costs still rely heavily on government funds, but alternative sources for ongoing sustainability are emerging.

The report brings remarkable context to current consideration of health information exchange at the highest levels. At this time of tremendous potential for positive advancement of these efforts, it will be a helpful tool for national, regional and state stakeholders as we evaluate emerging policy changes relevant to the eHealth Initiative and promote our common goals.

Marchibroda is chief executive officer for the eHealth Initiative.