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February 2010 St@teside

Strategic Approach Necessary for Widespread Use of Health Insurance Exchanges

The 2009 American Recovery and Reinvestment Act (Recovery Act) committed an estimated $40 billion to reach “meaningful use” of electronic health records (EHRs) in hospitals and physician practices.  According to John Glaser, senior advisor to the Office of the National Coordinator for Health Information Technology, the most important piece of this effort is for unaffiliated primary care doctors and hospitals to share EHRs through health information exchanges (HIEs).  While speaking at the National Health Information Exchange Summit in Washington earlier this month, Glaser explained that HIE development will take time and that the rate of progress among states will vary; however, the likelihood of significant growth of HIE coverage is now greater than ever since providers can receive Medicare and Medicaid payments for participating.

All 50 governors recently designated officials to promote HIE development across their states. Glaser noted that a central challenge will be convincing providers that they will definitely benefit from automatically sharing records with others.  Some of the other key challenges include:

  • Guaranteeing that HIEs meet legal and regulatory standards, including not favoring some providers over others
  • Getting electronic lab reports into EHRs
  • Establishing organization structures and operating rules that support providers’ shared objectives; and
  • Finding enough initial capital and sustainable long-term operating funds.

Glaser admitted that the process involved in achieving statewide HIE coverage will be “a hassle in some ways” and so providers must be reminded that their value as providers grows when their partnership grows.

Source:  “Statewide HIE Coverage Seen Bringing Big Benefits but Still Present Many Hurdles,” BNA Health Care Policy Report, February 15, 2010.