WASHINGTON  – The number of health information exchanges in the United States has increased over the past year, and more of the organizations are exchanging clinical data, according to survey results released Monday at the Health Information Technology Summit.

Janet Marchibroda, executive director of the eHealth Initiative, said the “Third Annual Survey of Health Information Exchange at the State, Regional and Community Levels” presents an optimistic assessment of progress.

“The first thing we found is the level of policy activity and leadership at the state level has increased significantly,” Marchibroda said. “This is moving very, very quickly at the state level – 10 executive orders from governors, and 36 bills passed in 24 states over the last 19 months.”

The eHealth Initiative surveyed 165 health information exchanges in 49 states, the District of Columbia and Puerto Rico. More than a quarter (45) identified themselves as in the implementation stage, while 18 percent (26) claim to be fully operational – that is, they are exchanging clinical data today.

According to the eHeath Initiative’s definition, that includes claims, dictation, emergency room episodes, enrollment and eligibility data, inpatient and outpatient episodes, laboratory results and radiology results.

These findings will only fuel the debate that has arisen over conflicting findings from other studies and reports released over the past year.

In June, the Health IT Transition Group reported that about 30 percent of RHIOs, or regional health information organizations, were in the production phase and exchanging live data. About 18 percent were considered in “mature” production. But a May 2006 study conducted by Avalere Health on behalf of the Agency for Healthcare Research and Quality reached a different conclusion.

“As we pulled back the curtain on these state-based projects, it became clear that publicly available characterizations of progress are generally overstated, and few projects are exchanging actual clinical data,” said Sheera Rosenfeld, senior manager of Avalere Health and primary author of the paper.

Qualitative differences are emerging from the data. Marchibroda said community-based organizations tended to focus on implementation, while state level organizations tended to expend efforts on policy development and planning.

One key finding from the 2006 study is that health information exchanges are turning to users of their services for ongoing funding. Marchibroda said that while the federal government continues to be the primary source of cash, exchanges are now seeking revenues from data providers and data consumer.

Of those organizations surveyed, 24 percent of respondents said they were receiving funds from hospitals, 21 percent reported receiving funds from payers, 16 percent were receiving funds from physician practices and 13 percent received funds from laboratories.

“This is the challenge of the next year, I think,” said eHI president John Glaser, CIO of Partners Healthcare in Boston. “We’ve got to find sustainable models to support these initiatives.”