Remember that funding for health information technology in the stimulus package? We know, it's been a little while, and when it comes to health reform, we've had a lot on our minds lately. But states haven't forgotten about health IT and the American Recovery and Reinvestment Act of 2009 boosted both their motivation and resources to get health IT programs up and running in two to six years. That states are interested in establishing electronic health information exchanges isn't exactly breaking news, but the recent progress in investment, implementation, and infrastructure is pretty exciting.

The stimulus package included the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), which lays the groundwork for advances in health care quality. Late in August, the Obama administration announced $1.2 billion of the stimulus funds would be released in the form of health IT grants, reports American Medical News.

The goal is to create a network of health IT centers, both regional and state-based, to help and support physicians and hospitals transitioning into electronic health record systems, says AMNews.

The initiative has two specific grant programs. The first makes available $600 million to set up approximately 70 regional health IT centers. According to AMNews, these centers would offer "technical assistance, guidance and information" to physicians and hospitals that want to become meaningful health IT users, with a special focus on helping primary care physicians and small group practices adopt EHRs. The second offers a total of $560 million -- plus technical and legal assistance -- to states that want to start their own state-wide health IT information exchange. HHS wants to make sure systems are both secure (just like electronic banking, health information should be private) and interoperable within states and across state lines (meaning information can go from your doctor's office to another's, or to a local hospital -- or a hospital hundreds of miles away).

Among others, Maine, California, New Hampshire, West Virginia, Texas, Vermont, Washington, Wisconsin, Rhode Island, Tennessee, Utah, and New York all are working on statewide systems. Here are some highlights:

Maine

In late July, Maine announced HealthInfoNet, a statewide health information exchange. According to Eastern Maine Healthcare Systems, the exchange represents collaboration between government and public health officials, physicians, insurers, consumers, employers, and non-profits. According to EMHS: 

In addition to regulatory oversight and internal security, HealthInfoNet has established Consumer Advisory Committee comprised of healthcare and computer experts, a number of consumer advocacy groups with strong interests in patient privacy, as well as educators.

New Hampshire

This summer, the New Hampshire legislature passed a set of guiding principles for a statewide exchange. New Hampshire hopes to use stimulus funds to further statewide use of health IT, and prioritizes information privacy. In a press release, state representative Cindy Rosenwald wrote:

This spring the New Hampshire legislature took a major step forward in advancing the adoption of Health Information Exchange among providers. House Bill 542 sets out the strategic framework, starting with principles developed by the Citizen's Health Initiative, to bring about the successful exchange of health information among an individual's doctors, no matter where they are located. The American Recovery and Reinvestment Act includes $20 billion to promote health information technology and exchange. When Governor Lynch signs HB 542 into law, New Hampshire will be poised to benefit from our share of the incentive.

New York

At a State Alliance for e-Health conference in August, NY State Department of Health Deputy Commissioner Rachel Block discussed New York's health IT strategy. Like Maine, New York's strategy requires cooperation between health care stakeholders and state government. This collaboration created the New York eHealth Collaborative (NYeC). According to its website, the NYeC represents a "public-private partnership that will serve as a focal point for health care stakeholders to build consensus on state health IT policy priorities, and collaborate on state and regional health IT implementation efforts." The goals of a statewide health IT infrastructure in New York are to:

• Support clinicians and consumers with information at point of care
• Advance care coordination
• Strengthen public health surveillance and response
• Enhance quality and outcome measures

Tennessee

According the Tennessee Office of e-Health Initiatives, Tennessee already established an e-Health Network, a secure health information sharing network in 95 counties. Additionally, the state has two Regional Health Information Organizations (RHIOs), CareSpark in the Tri-cities region of East Tennessee, and the MidSouth eHealth Alliance, Memphis in West Tennessee. Tennessee's goal is to align all health care stakeholders in a public-private partnership, to further improve their utilization of health IT and improve public health, quality of care, access to care, and lower costs.

Vermont

Vermont is a leader in health reform on a state level. While bringing down costs and covering more Vermonters over the past several years, the state also implemented health IT. In 2005, Vermont authorized the creation of the Vermont Information Technology Leaders (VITL), a non-profit, public-private partnership that laid down guidelines and goals for a statewide health information exchange. Vermont is renewing its push for meaningful, organized health IT use in a landscape improved by the economic stimulus package. The Blueprint for Health goals include making health information exchanges bi-directional, to share info between doctors, hospitals, labs, and public health registries. Vermont hopes this improved flow of information will improve quality, lower costs, and support care coordination, as it will speed up processes such as receiving medical lab test results.

When utilized properly, health information technology can improve quality of care, lower costs, and increase efficiency. States realize the value of health IT -- many were already working on implementing health IT before stimulus funds were available. The provisions in the American Recovery and Reinvestment Act are a great step forward, as they encourage and aid states that want to improve the quality and efficiency of health care through electronic information technology. For more information on regional and statewide health IT initiatives, click here, here and here.