HIE's top state e-health agendas

Health information exchange (HIE) action items top the list of states’ electronic health priorities, according to a newly released Commonwealth Fund report.That finding stems from a 2007 survey of states, in which 41 states and the District of Colombia responded. State officials were asked to identify their top two e-health priorities: 25 states identified HIE adoption, while 12 mentioned HIE policy development.“By far the most frequently cited priority area was developing and fostering local or state-level electronic HIEs to assure interconnectivity among health care providers,” according to the report.Nationwide, state and federally funded HIEs are in various stages of evolution. The four-year-old Indiana Health Information Exchange recently reported that the number of providers using its clinical messaging service nearly doubled in 2007. Meanwhile, the Brooklyn Health Information Exchange has been signing on technology providers of late as it prepares for a July launch.The Commonwealth Fund survey also revealed a focus on other aspects of e-health. Electronic medical records/e-health records, e-prescribing, and privacy/security issues were the third, fourth and fifth ranked priorities.The states also discussed obstacles in the path of HIE and health information technology deployment. Survey respondents cited obtaining funding for implementation and long-term operations as the “most significant barrier to the widespread adoption of interoperable HIT and a nationwide network of electronic HIEs,” according to the study.More than half of the responding states described lack of funding as the greatest barrier. Other impediments identified included difficulty in building a business case, the need to obtain stakeholder engagement, lack of standards, privacy and security concerns, interpretation of terminology, and legal constraints for e-prescribing.A team of researchers from Health Management Associates, George Washington University and the National Governors Association prepared the report.