HIE lessons of two states

By Patty Enrado
12:00 AM
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Healthcare IT leaders from Florida and Tennessee are sharing what they’ve learned about developing health information exchanges with other states and regions. Representatives from both states talked recently at a San Francisco forum about the problems they have encountered and how they solved them.

One thing Florida and Tennessee have going for them is strong support and leadership at the top. By executive order this past spring, Tennessee Gov. Phil Bredesen chartered Tennessee’s eHealth Advisory Council. The council is tasked with creating a plan to promote the use of electronic medical records throughout the state and identify barriers to the implementation of an effective health information infrastructure.

Florida Gov. Jeb Bush created the Governor’s Health Information Infrastructure Advisory Board in 2004 to advise the Agency for Health Care Administration as it develops and implements a strategy for electronic health record adoption and use. Representatives of the two emerging health information exchanges have plenty to offer.

Tennessee WISDOM

Mark Frisse, director of the regional informatics program through the Vanderbilt Center for Better Health in Tennessee, noted that the healthcare system is “anything but a system.” He called for more coordination among the various systems and a finance model built for Medicaid and the private market before standardization is adopted.

Because “the market is anything but a market,” he said, the industry needs transparency in quality and cost.

While acknowledging that states have power – with limits – Frisse listed the roles of things that states do well: conveners, employers, Medicaid, public health, regulators, legislators, agents of economic progress, market-makers and focus on long-term issues.

Frisse emphasized that sustained leadership and funding are critical. In Tennessee’s case, Governor Bredesen was personally involved in the Memphis HIE project (Midsouth eHealth Alliance) and the Commissioner of Finance and Administration was equally engaged. Tennessee gave a significant sum of money on top of the AHRQ funding that the Memphis project received.

Florida lessons learned

Michael Heekin, chairman and founding board member of the Florida Governor’s Health Information Advisory Board, said stakeholders are “generally supportive” of the Florida Health Information Network.

Heekin recommends that states implement pilot projects quickly so that everyone involved can understand the network as it evolves in the real world and move away from a health information network as an abstract concept. “It’s important to be good stewards of available resources in the early phases of the initiative,” he said. In other words, “keep your friends close, but your money closer.” There is no sense in reinventing the wheel, he said, so states should share resources and lessons learned.

“It’s harder than we thought to get the state government enterprise itself to row in the same direction, but it’s really important to do,” Heekin said. While Florida is not there yet, it is working with various agencies, to help coordinate technology and programs to ultimately access patient information from the respective agency databases.

States need to keep the noise from nitpickers and naysayers down. “Just start the race and handle the issues one at a time,” Heekin said.