Effective partnerships between state and federal efforts in the years ahead will be critical to the success of national efforts for transformation to a value-driven healthcare system, according to a report released by the Foundation of Research and Education (FORE) of the American Health Information Management Association (AHIMA). The report is an extension on the 2006 study on development of state-level health information exchange (HIE) initiatives, under contract to the Office of the National Coordinator (ONC).

"HIE initiatives all have a mission of improving quality through sound information practices; quality/ transparency initiatives require accurate information. These two cornerstones of a value-based healthcare system must be coordinated at federal, state and local levels and across the public and private sectors" AHIMA's CEO, Linda Kloss, MA, RHIA, FAHIMA, told the American Health Information Community (AHIC) on January 23. "This is a very critical moment in time to achieve a coordinated strategy that will use information to improve care and help people make informed choices."

The project's Steering Committee, made up of representatives from nine state-level HIEs and industry experts, provided the following recommendations:

1. The federal government should consolidate oversight of health IT and quality/transparency initiatives under AHIC.
2. The Secretary should design the successor to AHIC and transition it to a public-private organization by 2008.
3. Each state should establish or designate a consolidated, public-private health transformation governance mechanism that includes at least health information exchange and quality/transparency; a formal liaison to AHIC should be established through a new workgroup of states.
4. The federal government, to the degree possible under statute, should fund transformation efforts through or under the guidance of formally recognized health transformation entities in each state and provide strong leadership through CMS policy.

"There is urgency to these recommendations because states are full participants in the health IT transformation," adds Laura L. Adams, member of the projects Steering Committee and CEO of Rhode Island Quality Institute. "The recommendations outlined are integrative strategies to prompt a healthy and public discussion about how to coordinate national and state efforts-public and private-to transform healthcare through information."

The study was conducted between September 15 and November 15, 2006. Under guidance of the project's Steering Committee, the project extension looked at four aspects of the operation of state-level HIEs:

* Coordination between state and federal health IT and related initiatives
* HIE services that have achieved financial sustainability,
* The role of public payers and state-level HIE, and
* The relationship of state-level HIE and quality/transparency initiatives.

The survey methods, findings, and recommendations are detailed in the project reports which can be found at www.staterhio.org.

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