Key Activities in Health Information Technology (HIT) and Health Information Exchange (HEI)
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Key National Activities:
Enactment of the Health Insurance Portability and Accountability Act (HIPAA) of 1996
President Bush announced his vision for the widespread adoption of interoperable electronic health records by 2014 (April 2004)
Establishment of the Office of the National Coordinator for Health Information Technology (ONCHIT) in the federal Department of Health and Human Services (April 2004)
Creation of the Certification Commission for Healthcare Information Technology (CCHIT), a voluntary, private-sector organization to certify HIT products on functionality, interoperability and security (July 2004)
Authorization of the Commission on Systemic Interoperability by the Medicare Modernization Act; development of a strategy to make health care information instantly accessible at all times, by consumers and their health care providers (January 2005)
Creation of the HIT Standards Panel (HITSP) which brings together public-private stakeholders to harmonize the existing information technology standards used to exchange healthcare data in the U.S.
Development of the Health Information Security and Privacy Collaboration (HISPC), a partnership focused on addressing variations in business policy and state laws that affect HIE
President Bush signed an executive order, promoting quality and efficient health care in federally administered or sponsored health care programs. The executive order required federal compliance by January 1, 2007 (August 2006)
Current federal legislation - Senate Bill 1418 and House Bill 4157, focusing on HIT, will be combined to support the adoption, implementation and increased utilization of technology in our health care system
Current HIT Bills of Interest in Congress:
S1408 HIT Act of 2007 is designed to improve quality in health care by providing incentives for adoption of modern information technology
S628 Critical Access to HIT Act is designed to provide grants for rural health IT development activities
HR3800 Promoting HIT Act is designed to advance adoption of interoperable HIT and to improve quality and reduce health care costs
S1693 Wired for Healthcare Quality Act establishes the American Health Information Community to create and maintain a nationwide interoperable health information technology infrastructure
HR1952 provides financial incentive to small medical providers to implement a national health information infrastructure
HR2377 Secretary of Health and Human Services will develop criteria for certification standards for electronic exchange of health information
S2812 Medicare Telehealth Improvement Act allows more facilities and providers to get paid for providing care through the use of telemedicine
Key North Dakota Activities:
Senator Conrad's North Dakota Health Information Technology Summit (April 2006)
Formation of North Dakota HIT Steering Committee and Stakeholder Group (April 2006)
North Dakota HIT Steering Committee vision/mission and immediate goals developed (November 2006)
HB 2303 (sponsored by Senator Lee and Rep. Price) introduced during the 2007 legislative session to formalize the creation of the HIT Steering Committee and provide for an HIT grant program (January 2007)
HB2303 failed - an amendment was then made to HB 1021 of the Information Technology Department’s appropriation bill which was adopted. This amendment codified the committee by adding a new section to North Dakota Century Code 23-01. No funding was appropriated. (March 2007)
Five members of the Steering Committee represented North Dakota at the Region VIII HIT round table conference in Utah (May 2007)
Five workgroups were created which meet monthly to continue work in the areas of HIE applications, education/communication, legislative policy, privacy/security, and finance/resources (August 2007)
The Center for Rural Health, with input from committee members, will develop and administer statewide surveys to hospitals, clinics and long term care facilities to assess the HIT environment in the state (May 2008)
North Dakota HIT Steering Committee/Stakeholder Group will hold the third annual face-to-face strategy meeting June 4-5, 2008 in Bismarck.
Health Information Exchange initiatives continue to mature, with 32 fully operational health information exchange initiatives. Five exchanges ceased to exist in 2007, with 15 new exchange initiatives created in 2007.
State policymakers continue to demonstrate leadership in using health information technology and health information exchange to drive improvements in health and healthcare. Since 2006, there has been a nearly two-fold increase in state legislation proposed relating to health information technology (HIT). These bills increasingly represent a general trend towards greater linkage between improving healthcare quality and health IT.
The most important drivers for implementing HIT/HIE initiatives include those related to improving quality, improving patient safety and addressing inefficiencies.
Primary focus of health information initiatives. Supporting direct care delivery continues to be the focus of health information exchange efforts, but providing population health related services continues to be an emphasis for some-particularly more advanced stage initiatives. Health information exchange initiatives are increasingly adding support functions to augment data services.
Health information exchange initiatives are continuing to formalize their operations through the creation of formal legal entities. Fifty-five percent have established legal corporations, of which 68 percent have chosen a non-profit corporation model.
Clinicians, community health centers, employers, health plans, hospitals, patients and quality improvement organizations are most likely to play a governance role in health information exchange efforts.
Operational initiatives offer guidance for success. Three quarters of operational initiatives are no longer dependent on grants or advance payments. They derive their revenue from hospitals, physician practices, private health plans, laboratories, federal government and philanthropic organizations. Most start-up funding comes from the federal government or hospitals.
In 2007 – 30 separate pieces of legislation have been passed in 19 different states which focus on building the capacity of health IT.
