Most CIOs /CMIOs that I know focus efforts everyday on strategies, planning, building or maintaining complicated information exchanges within their own enterprises by developing and deploying transformational information technology that improves the delivery of care and streamlines administrative services. Most recognize the need for a strong partnership between the Health Information Technology (HIT) team and leadership. They are acutely aware that transformation is a fundamental change in the way a health system or community delivers and/or administers healthcare, enabled by health information technology, with documented improvement in quality and efficiency.
Some CIOs/CMIOs that I know have devoted countless hours to community HIT collaboration efforts by educating, promoting standards and providing expertise that might someday lead to Health Information Exchange (HIE) beyond the community. However, they understand the costs, the technology costs and the industry limitations of the HIT that they purchase and contract.
A 2009 eHealth Initiative survey found that “meaningful use” will redefine how HIT will be used and place strong emphasis on the ability of providers to exchange information through Medicare and Medicaid payments. Those CIO’s that have been involved and who have pioneered HIEs and can envision the capabilities that can support care as clinicians become meaningful users of electronic health records (EHRs).
Now the States are active in HIEs and are forging ahead with their plans to create Statewide Exchanges. I often ask, “Where are the CIO’s and CMIO’s at the table?”
Community, governmental and non-government policy makers who are at the design table say that CIO’s/ CMIO’s are not the only decision makers in how funds are budgeted. I can buy that, but wait!
They tell me that the work that CIO’s/CMIO’s are doing should be part a larger plan that the hospital and health systems executives support. I can buy that too!
Finally I hear, if CIO’s/CMIO’s had the level of understanding of technology and the
capabilities that HIEs offer then they might have an entirely different conversation at the drawing table.
Then comes the question, “Who will pay for the Statewide HIE ?” Repeatedly, I am told that the costs should be paid by those that benefit the most and the Feds have not provided much guidance in working this out other than stating that HIEs can “pioneer” in this area. States are definitely struggling in finding a revenue model that accomplishes HIE sustainability goals.
I would like to excite your thoughts here…..and any ideas would benefit the cause!