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Two states took very different paths to health information exchange

My colleague Lorraine Fernandes recently shared her thoughts on the eHealth Initiative’s National Forum on HIE. While I agree with her conclusions, sitting in the audience listening to representatives from more than 40 states that day, I couldn’t help but be struck by two other observations:

1)  The United States is more rural than most of us picture it. I think I heard representatives from every state but Delaware talk about how rural their state is, and she must have just forgotten to mention it.

2)  The more unique you think your state is in terms of developing a plan to address HITECH regulations for State HIE, the more ordinary you actually are. Every state is unique. Unique is the new black, as they say.

HITECH guidelines wisely gave states a wide swath to forge their own way based on the requirements of each of their stakeholders, geographies and population mixes.  As a result, there is a wide range of approaches to statewide HIE.

Take the examples of New Mexico and New Jersey, two states with vastly different approaches who will be sharing their stories at the upcoming MMIS conference (August 15-19 in Portland, OR).

In 2004, Lovelace Clinic Research Foundation created the New Mexico Health Information Collaborative (NMHIC) through a grant from the Agency for Healthcare Research and Quality (AHRQ). NMHIC’s goal was to establish a framework for HIE that could be extended to the rest of the state.

To achieve this, they set about connecting the largest health care facilities so that they could incorporate the most data possible using the fewest data interfaces. So, when the HITECH act mandated that each state name a state-designated entity for HIE, NMHIC was a natural fit.

Since then, the organization has assembled a diverse group of stakeholders, including technology partners, healthcare organizations (many of which were already sharing data with NMHIC) and state agencies to develop a governance model that will allow all healthcare communities to be engaged in HIE. Read more about New Mexico’s success in a recent blog post.

Now for New Jersey: like many states, rather than creating a foundation based on a traditional HIE framework, New Jersey is anchoring their HIE activities to Medicaid.  New Jersey recognized an opportunity to use CMS funding to  build a statewide Medicaid HIE that could then be leveraged as a key component of the state’s plans for HIE.

This approach will ultimately combine four regional HIEs with the state’s Medicaid HIE to cover the state from a “bottom up” approach.

From an early start New Jersey has emphasized the importance of Medicaid in the overall state HIT program as well as the need to embrace healthcare reform in the state’s HIT vision and strategy planning.

These two different states have two different approaches to create a framework that will ultimately link healthcare organizations with state agencies with payers and labs and pharmacies in order to deliver on the goals and objectives of HITECH: improve quality of care, increase efficiencies and reduce costs.

What is the common denominator between these two states and the many others that are developing their unique roadmaps for HIE? A Master Person Index (MPI) that can bridge the gap between traditional HIEs and Medicaid agencies to provide a trusted, unified view of patients and providers for effective health information exchange.

Regardless of which strategy a state chooses to build its HIE foundation (and I am sure we will see many more unique examples), an MPI can be leveraged across information sharing initiatives to form both a foundation for current HIE efforts (providing interoperability between disparate source systems) and a basis from which a sustainability plan can be extended into initiatives like public health reporting or e-prescribing.

You can learn more about how New Mexico and New Jersey are embarking on their statewide HIE architectures at the MMIS conference on August 18. Dave Perry, CIO of NMHIC and Michelle Romeo, CIO, New Jersey Department of Human Services will discuss each state’s approach to HIE in more detail. To learn more about how Initiate MPI technology is supporting information sharing needs across HIEs, visit us in booth #5.