Supporting Alliances for Health IT

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<p>Three-quarters of U.S. states are developing capacity for electronic health information exchanges (HIE), which enable health care organizations to integrate health care information, improve the quality of care, and decrease costs. While many states have attempted to implement HIE through regional alliances of physician practices, hospitals, pharmacies, laboratories, and other stakeholders, many of these alliances close within a year of startup.</p>
<p>In a <a href="/Content/Publications/In-the-Literature/2009/Mar/HEAL-NY-Promoting-Interoperable-Health-Information-Technology-in-New-York-State.aspx">new Commonwealth Fund-supported study</a> in <i>Health Affairs,</i> researchers at Weill Cornell Medical College examine an ambitious, innovative New York State program that is helping these alliances pursue implementation of HIE, interoperable electronic health records, or electronic prescribing. They say that the Healthcare Efficiency and Affordability Law for New Yorkers Capital Grants Program (HEAL NY)—which plans to invest $250 million in health IT—has changed the state’s health care landscape.</p>
<p>So far, $160 million in HEAL NY grants have been awarded and $230 million in private sector dollars committed to health IT infrastructure. All alliances that received grants in 2006—which averaged $1.8 million each—remain in operation, the researchers say, in contrast with the high failure rate found in other states. Still, only about one-third of grantees had users, reflecting the newness of the initiatives and the difficulties of implementing the technologies.</p>
<p>Study coauthors Lisa M. Kern, M.D., Rainu Kaushal, M.D., and colleagues point out that across the nation, financial sustainability is a concern for communities implementing interoperable health IT. Robust reimbursement models are necessary, they say, including those that would share costs and benefits across stakeholders. </p>
<p>In <a href="/Content/Publications/Literature-Abstracts/2009/Mar/What-It-Takes-Characteristics-of-the-Ideal-Personal-Health-Record.aspx">another Fund-supported study</a> in the same issue of <i>Health Affairs,</i> a research team led by James S. Kahn, M.D., of the University of California, San Francisco, argues that a lack of products with real value for consumers may be a primary reason for the slow adoption of personal health records. Although Americans generally want online access to their health information, few products have been designed to automatically obtain financial or clinical data from health providers, requiring individuals to update them manually. Kahn and his team say that development challenges have been magnified by the partial implementation of federal regulations for the secure exchange of health information, which is critical to integrating data from multiple sources.</p>