Drawn from the report, States' Roles in Shaping High Performance Health Systems.

States shape the health system in many ways, influencing key components such as insurance coverage, quality of care, and information and provider infrastructures. This report presents findings from the State Health Policies Aimed at Promoting Excellent Systems project, undertaken by the National Academy for State Health Policy, with support from The Commonwealth Fund. After conducting surveys of multiple agencies in states across the country, as well as review of related literature, this study found that states are pursuing system improvements across the full spectrum of their authority, including health care purchasing, regulation of providers, reporting of performance data, integration of public health with health care approaches, and improving the availability and affordability of health insurance. Despite this activity, this study finds room for states to do much more. Ongoing efforts to track, study and diffuse information on state activities could accelerate adoption of promising polices and practices.

Connecticut has begun an effort to develop a range of electronic infrastructure tools that will be shared across health care providers to speed the delivery of necessary health care services. The non-profit eHealth Connecticut project was launched in 2006, and has plans to develop the following tools:

• Health Information Exchange and e-Prescribing with the Connecticut State Department of Social Services, including a master database of diagnoses, medications, allergies, and adverse drug events for all state Medicaid recipients
• Aggregating quality measures at the individual provider level, to allow for enhanced public reporting and the development of pay-for-performance
• Data-sharing among hospital emergency departments, including the development of a master person index to merge records for a single individual from multiple different sources
• Emergency preparedness, to develop secure electronic health records for all state residents in the event of a statewide emergency or health crisis.

  State officials sit on the eHealth Connecticut board to give input and guidance to the public–private partnership. The program held its first summit in March 2006, which introduced participants to ideas about health IT and identified potential challenges, such as privacy concerns and the need for buy-in among community health care providers. A follow-up meeting provided a forum to share the lessons and challenges of planning and implementing projects throughout Connecticut.

  Sources: Connecticut Governor's Office SHAPES survey response, and eHealth Connecticut website, http://www.ehealthconnecticut.org/.