A new informational tool from ONC provides examples of the distinct paths states have taken to establish HIE connection or interoperability.
While some states appoint an oversight entity to govern or encourage health information exchange (HIE), others put laws on the books or create policies that mandate interoperability, require the use of health IT standards or dictate connection to an HIE.
The Office of the National Coordinator for Health IT (ONC), in its newly published State Health IT Policy Levers Compendium, explains that the latter path — establishing an HIE connection or interoperability mandate — “by definition is used to advance interoperability.”
The compendium, available for use in dashboard form here, contains 32 policy levers and more than 300 examples of how states use their levers to promote health IT and advance interoperability. The policy category “HIE Connection or Interoperability Mandate” reveals activity examples in the following five states:
Maryland — Under state law, effective Dec. 1, 2011, each hospital under the jurisdiction of the Health Services Cost Review Commission (HSCRC) is required to electronically connect to the state-designated HIE to enable HSCRC to fully measure hospital-specific performance on readmissions. [Source]
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Minnesota — The 2015 Interoperable EHR Mandate required that by Jan. 1, 2015, all hospitals and healthcare providers across the continuum of care had to have an “interoperable electronic health records system.” The statute also requires a statewide plan to meet that goal, including uniform standards to be used for sharing and synchronizing patient data across systems. In addition, providers must connect to a state-certified health information organization, either directly or through a connection facilitated by a state-certified health data intermediary. [Source]
Texas — State legislature directed the Health and Human Services Commission (HHSC) to develop an electronic HIE system. Further, Texas lawmakers directed HHSC to ensure that IT systems used by HHS agencies are interoperable with each other — as well as with external IT systems — in receiving and exchanging electronic health information. [Source] See related recent news here.
Utah — A state law passed in 2008 authorizes the Department of Health to adopt standards for electronic health information exchange. Payers and providers must use those standards to exchange health information between healthcare systems. However, those parties are not required to use the standards when electronically exchanging health information within a healthcare system. [Source]
Vermont — The state has three associated activities. Act 48 requires a review of the scope of health IT to ensure that the full range of technology related to healthcare reform is included. Act 128 also requires hospitals, which operate most of the clinical laboratory services in the state, to maintain interoperable connectivity to Vermont Information Technology Leaders (VITL), the state’s single HIE, as a condition in their annual budget-approval process. VITL was established by law and mandated to provide specific services to the Vermont healthcare environment. [Source]
ONC notes that it collected information for the compendium in coordination with state governments. The agency describes the compendium as a “living document that requires continuous collaboration and engagement with states and other entities to identify all levers and activities used by states to promote health IT and advance interoperability.”
ONC expects to provide periodic updates to the compendium. The document is not intended to represent a comprehensive analysis of all relevant policies, nor does it represent endorsement of any particular policy lever or activity, according to the agency.
Date: December 17, 2015