Dear HITCh members,

October 25, 2007

This e-news update includes the following:

New Report From State-Level Health Information Exchange Consensus Project
Minnesota Builds the Foundation for Health Information Exchange

State-Level Health Information Exchange Roles in Ensuring Governance and Advancing Interoperability

The State Level Health Information Exchange Consensus Project, in which NCSL participates, recently released a preliminary report on State-Level Health Information Exchange: Roles in Ensuring Governance and Advancing Interoperability. The report provides an overview of the current role of state-level health information exchange (HIE) and discusses a potential framework for organizing HIE functions and formalizing organizational and sector roles and responsibilities. Comments on the paper from stakeholders are being sought at a conference the Project is holding in Washington D.C. November 5-6. If you cannot attend the meeting and wish to provide input on the paper, please send comments to me and the NCSL representative at the meeting will include them in the discussion.

Key points from the report:
The primary roles for state-level HIEs are governance and technical operations. The report identifies three primary functions of most HIEs: convening, coordinating, and operating.

Convening: State-level HIEs must establish a trusted, independent and collaborative process for education, negotiation and decision making among a diverse group of stakeholders lacking a history of working together. Succeeding at this function is essential for a successful HIE.
Coordinating: This function is aimed at ensuring coherent and consistent policies within all groups participating in a HIE and across HIEs. In particular this coordinating across HIE bodies is necessary on privacy and security issues.
Operating: This function is the technical side of the HIE. The choices faced here include what technical model to choose for interoperability and how to establish a sustainable business model

Make up of HIEs
Most state-level HIEs are currently advisory bodies. Nearly all of these groups plan to transition to public-private partnerships. In the context of HIE, a public-private partnership reflects the need to fully engage both the public and private sectors of the health system in sharing data, financing governance, and resources for share HIE infrastructure.

Preliminary Recommendations

1. Standards and associated qualification criteria and methods for accrediting HIE entities should be developed related to both of the two primary organizational roles (governance and technical operations).

2. Each state should support and participate in a single state-level public-private entity that takes on a distinct state-level HIE governance role, affording it recognition and authority as appropriate, and enabling it to receive particular types of financial and nonfinancial benefits.

3. The state-level HIE governance role must include consensus-based implementation of HIE policies and practices, particularly related to privacy and security, that are consistent with state and federal laws.

4. States should designate a formal point of leadership and coordination within state government to facilitate HIE participation, investments, and strategies across the executive branch and agencies.

5. States and state-level HIEs should work in concert and develop mechanisms to

advance interoperability through the increased adoption of certified technology and other standards.

Minnesota builds a foundation for HIE

Minnesota recently updated its health date privacy laws to provide for robust health information exchange. To learn more about the Minnesota initiative see this State Health Notes article http://www.ncsl.org/programs/health/shn/2007/sn501a.htm.

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