NEW YORK – networking initiatives form and take shape, a growing number of statewide initiatives are under consideration.

As of early 2005, at least 15 states have some form of electronic health record or networking initiative under way. The eHealth Initiative lists 23 states that are considering some kind of data sharing or networking initiative.

The idea of sharing health data throughout a state isn't new. In fact, 10 years ago, several states were trying to implement community health information networks. However, immature technology, high costs and poor business cases doomed almost all of them.

Now, several state networks have received seed funding to begin their data-sharing efforts. For example, the Agency for Healthcare Quality and Research in October awarded grants of $5 million to five states – Colorado, Indiana, Rhode Island, Tennessee and Utah.

In light of the growing interest by states, eHealth Initiative has created a State Policy Summit Initiative, to help states prepare to launch and support successful regional health information organizations.

The effort will support HIT agendas in at least three to five target states, with the hope that the experiences in the target states will provide lessons and models for replication, said Janet Marchibroda, eHI's president and CEO. At least two state summit meetings were planned for 2005 by eHI.

State network initiatives represent a "significant trend," said William S. Bernstein, healthcare industry partner with the law firm of Manatt, Phelps & Phillips in New York. "Federal action is purely required, but it's fabulous to see so many states getting involved."

Bernstein said he's working with a budding network in Nebraska, as well as continuing efforts in Tennessee and New York.

Most recently, in Maine, a state hospital commission recommended the creation of a statewide medical records system to enable access to patients' clinical information. Under the plan, healthcare workers could view patient records from any hospital in the state.

Efforts are probably the farthest along in Indiana and Massachusetts.

Indiana, the recipient of an AHRQ grant, wants to expand an Indianapolis-based health information network to serve providers around the state. In Massachusetts, efforts are under way to select three communities en route to creating a statewide system in place within five years. Blue Cross Blue Shield of Massachusetts is providing $50 million in funding for the project.

Statewide efforts seem most effective in smaller states, where populations may be covered effectively by one network, Bernstein said.

Even though a variety of state initiatives are starting, they'll have a hard time becoming a reality, said Ann Woodbury, chief health advocate for the Washington-based Center for Health Transformation. "There are more local initiatives, and not as many border-to-border efforts," she said.

Funding will be a key indicator for success for any health network, said Donald Gravlin, vice president for Capgemini Health, New York. It will take a big financial commitment, and many states may not be able to provide that help, he said.