States at the Center of Health Information Exchange

States are in a unique position to encourage health information exchange (HIE), or the electronic transfer of health care information across organizations. [1] They are critical to the federal vision for an interoperable National Health Information Network and have considerable leverage to influence local investments in health information technology. About half of the states have an executive order or legislative mandate to stimulate the use of health information technology, and 35 states have initiated the planning process. Still, only seven states have plans in place and implementation under way. [2]

States can encourage health information exchange in their roles as policy leaders, funding sources, data collectors, facilitators, or neutral conveners.[3] They can leverage their roles as major health care purchasers and policymakers to drive collaboration—reaching across public and private sectors to build support among the many stakeholders that are needed to create, operate, and sustain HIE networks.

"The states that are leading health information exchange have several things in common," says Neva Kaye, policy director at the National Academy for State Health Policy (NASHP). "They all have a clear vision for making the system better, political support for that vision, and a clear sense of the state's responsibility to bring about change."

Below we examine two states, Arizona and Florida, that have played active roles in promoting health information exchange and building effective public/private partnerships. Arizona and Florida started out with a similar vision—to improve patient care by expanding electronic health records and health information exchange—but they followed different strategies to fit the circumstances of their state.