Most states working toward implementing e-health programs

A national survey found there is significant interest in using technology for health data exchange. But it also found interest doesn't always translate into action.

By Pamela Lewis Dolan — Posted April 14, 2008

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States consider e-health to be a high priority, according to a new study by the National Governors Assn. and Health Management Associates. But many find there are strong barriers to using technology to share health information.

The study, "State E-Health Activities in 2007: Findings From a State Survey," released in February, was funded by The Commonwealth Fund and the National Governors Assn. It found that the District of Columbia and the 41 states that participated in the study felt that e-health was important, with 70% responding that it was very important.

But the states varied in terms of what e-health activities they deemed the most significant, ranging from e-prescribing to chronic disease management. They also varied in the number and kinds of obstacles that prevented those activities from taking place, barriers such as privacy laws, technical challenges of securing data, project funding and a lack of collaboration among project stakeholders.

The study's authors said that important goals, including those that might lead to a nationwide health information network, remain on the horizon. The study concluded that virtually all states now are "actively engaged in the promotion and implementation of e-health strategies," but that "the challenges are significant" in an "undertaking that will be well worth the effort."

"I would say a trend to track would be the formation or expansion of operational regional or statewide" electronic health information exchanges, said Kathleen Gifford, a study co-author and a principal at Health Management Associates, which funded the study.

"Obviously, increases in the number of eHIEs or other increases in the scope of eHIE activities would suggest that various barriers are being addressed and to some extent overcome" such as privacy, security, standards and funding, she said.

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States' top e-health priorities

In a survey, 41 state governments and the District of Columbia identified the two most significant electronic health initiatives.

Initiative States
Electronic health information exchange adoption 25
Electronic HIE policy development 12
Electronic health and medical records 9
E-prescribing 7
Privacy and security issues 5
Quality and transparency 3
Telehealth 3
Public health registries 2
Personal health records 2
Medicaid system upgrades 1
Other 6

Source: "State E-health Activities in 2007: Findings From a State Survey," The Commonwealth Fund and National Governors Assn., Feb. 15

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Barriers in sharing data

States were asked to identify the most difficult program area in which they faced releasing health information through an electronic data exchange. The percentages represent 41 states and the District of Columbia that responded to the survey.

Program area Percentage of states
Mental health 17%
Substance abuse 16%
General 11%
Communicable disease 9%
Genetic testing 9%
Adolescent 8%
School-based 8%
Disability 8%

Source: "State E-health Activities in 2007: Findings From a State Survey," The Commonwealth Fund and National Governors Assn., Feb. 15

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