States at "Ground Zero" for Exchange of Health Information

National coordinator for health IT Dr. David Blumenthal told state Medicaid IT directors that they stood at "ground zero" in the health information exchange policy and technology hierarchy.  “This is in many ways ground zero for much of what my office and the Medicaid program and the federal health agenda have to accomplish,” Blumenthal told an audience of over 400 government IT officials attending the Medicaid Management Information Systems Conference in Chicago this week.  Dr. Blumenthal said states and local jurisdictions will be responsible for building the infrastructure on which health information exchange will operate. That means states also bear the burden of solving policy conflicts that will arise when health exchange transactions cross state lines.

States' success managing this jurisdictional “thicket” is essential to federal plans to finance a nationwide system of health information sharing.  “We won’t be successful unless you all take the initiative to find ways of allowing information to move across the jurisdictional boundaries that patients do not recognize when it comes to getting the care that they need,” Dr. Blumenthal said in recent remarks.

Dr. Blumenthal stressed that increasing social mobility required cross-jurisdictional care coordination. Citing a personal example, he said he routinely saw patients from other New England states when practicing medicine in eastern Massachusetts earlier in his career.

“Many of your states have medical markets that cross jurisdictions; so it’s going to be very important that you coordinate not only with the providers in your own communities but that you coordinate across state lines, difficult as that may be,” he said.

A good part of the difficulty stems from health information privacy protections that differ from state to state. Although the HITECH health IT funding law strengthened federal privacy regs, several states have imposed additional health information privacy requirements of their own, Blumenthal noted.

To assist in these efforts, Blumenthal said he hoped “in the very near future” to be able announce a “program or programs” involving $300 million Congress set aside in the HITECH legislation to provide states support in expanding heath information exchange.

Comments

[Tom White]

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