Effective lobbying in the legislature is one key to a successful health information exchange for a state, according to two state HIE leaders who spoke at a recent conference in Dallas.
The speakers – Gina Perez, executive director of the Delaware Health Information Network (DHIN) and Devore Culver, executive director of Maine’s HealthInfoNet – lead state HIEs that are regarded as among the more successful ones in the nation. Data exchange has been under way for about a year in Delaware and is just getting under way in Maine.
Both speakers said the financial support of the state legislature was vital to their starting up, but it did not come easily. There were many misunderstandings and stumbles along the way.
In Delaware, the legislature laid the groundwork for the HIE in 1997 but did not provide funding. Two federal grants enabled DHIN to get organized, and in fiscal 2007 the state legislature provided $2 million in upfront capital that required a dollar-for-dollar match, Perez said.
When DHIN’s founders raised the matching money, they got $3 million from the legislature the following year, again with the matching requirement. This year DHIN has asked for $2.5 million in state funds, and the prospects are good, Perez said. “The legislature now sees the value” of the network, she said.
Perez and Culver both argued that health information exchange is a public good, but it’s difficult to explain that to legislators, they said. The biggest hurdle is simply explaining how HIE works.
Legislators are aware of the health care crisis, and “they’re looking for a silver bullet,” Culver said. HIE is not a silver bullet but is one of the few things that you can do that might make a difference in the health care delivered to many people, he added.
Culver and Perez spoke about HIE sustainability at a conference sponsored by the Office of the National Coordinator of Health Information Technology.
Although they described several ways they expect to generate revenue for their operations, Culver said that HIE “is not going to be sustainable in itself.” Continued state funding – warranted by measurable improvements in health care quality and reductions in medical errors – is likely to be needed, he said.
Perez warned, however, that lobbying and public relations can go too far. “If you have to spend too much time selling the idea, then maybe you need to re-evaluate the idea,” she said.
Government Health IT presents Rick Friedman, director of the division of state systems for the Center for Medicaid and State Operations with the U.S. Department of Health and Human Services, in this recent eSeminar regarding how the federal Centers of Medicare and Medicaid Services is partnering with state Medicaid and health and human services officials to bring Medicaid into the digital age. Paul McCloskey, Government Health IT editor, moderates.
