HEAL NY: Promoting interoperable health information technology in New York State
Weill Medical College of Cornell University, Department of Public Health, in New York City.Health Affairs (Impact Factor: 4.97). 03/2009; 28(2):493-504. DOI: 10.1377/hlthaff.28.2.493
Through a novel, ambitious program called HEAL NY, New York State plans to invest $250 million in health information technology (IT) that can be linked electronically to other health IT systems. In contrast to high rates of closure by other organizations attempting health information exchange (HIE), 100 percent of HEAL NY Phase 1 grantees still existed two years after awards were announced, 85 percent were still pursuing HIE, and 35 percent had actual users. The number of grantees meeting basic criteria for regional health information organizations (RHIOs) increased. Although it is early, lessons learned can inform state-based initiatives nationwide.
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- "Notable state examples include Delaware's Health Information Network in 1997 ; Florida's e-prescribing program for Medicaid in 2003 ; and the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) in 2005 which established a statewide HIT infrastructure for healthcare system transformation . HEAL NY is particularly noteworthy as it is the largest state-based public investment to promote EHR adoption and HIE development . To date the investment in interoperable HIT and HIE in New York State is approaching US$800 million. "
ABSTRACT: Objectives In the US, the federal and state governments are supporting interoperable health information technology (HIT) and health information exchange (HIE) through policy interventions and financial investments. However, private healthcare organizations and partnerships have also been active in establishing exchange activities, promoting interoperability, and developing technologies. This combination of influence from different actors has resulted in a rapidly changing healthcare environment. In this context, we sought insights into the optimal roles for the public and private sectors in HIT/HIE policy development and implementation Methods We leveraged the concurrency of federal and New York State initiatives to spur HIT/HIE adoption by interviewing HIT experts (n=17). Interviewees represented federal and state government agencies, healthcare providers, and exchange organizations. A semi-structured interview guide with open-ended questions covered the domains of organization, value, privacy, security, and evaluation. We analyzed transcripts using a general inductive and comparative approach. Results Interviewees assigned roles for standard setting and funding to the federal government and suggested states were better positioned to offer implementation support. Interviewees forwarded a public-private partnership model as a potential solution to the limitations facing the private and public sectors. Conclusions HIT/HIE policy is a complex issue involving standards, privacy, funding and implementation. When New York State began funding HIT, significant federal intervention did not exist. Since the launch of New York State’s program and the subsequent federal Meaningful Use criteria, interviewees expressed distinct but complementary roles for both state and federal governments and saw an avenue to include the private sector through public-private partnerships.
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- "The Beacon Community program funded 17 communities to demonstrate the benefits of health IT, including building and strengthening HIE. These HITECH programs may be a catalyst for local change and further investment, and some states have expanded upon HITECH with further investments in infrastructure including HIE support . "
ABSTRACT: Frankel and colleagues have compared Israel and the U.S.’s experiences with health information exchange (HIE). They highlight the importance of institutional factors in fostering HIE development, notably the influence of local structures, experience and incentives. Historically, information infrastructure in the U.S. has been limited due to lack of standards, fragmented institutions and competition. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized billions of dollars for the adoption and “Meaningful Use” of electronic health records. HITECH programs and Meaningful Use incentives target the advancement of HIE through 1) building blocks, 2) local support and 3) payment incentives. Meaningful Use requirements create a roadmap to broader electronic exchange of health information among providers and with patients. Ultimately, successful HIE in the U.S. will depend on whether Meaningful Use can address institutional needs within local markets. This is a commentary on http://www.ijhpr.org/content/2/1/722
- "No single reason dominated the analyses of failure. On the other hand, analysis of a successful HIE project in New York state attributes the success primarily to substantial state funding and extensive stakeholder participation in the implementation process [Kern et al., 2009]. "