Although Lori Evans hasn’t had much time lately to pursue her hobby of flying small planes, she’s soaring in her role as New York state’s health information technology advocate.
In March, the state handed out $105 million in grants to develop regional health information organizations. That amount is on top of the $53 million the state invested in RHIOs in 2006, before Evans took the job of deputy commissioner of the New York State Department of Health’s Office of Health IT Transformation. Other initiatives, such as a privacy protection framework for health records, are also beginning to show progress, she said.
Evans’ health IT career began a decade ago at Kaiser Permanente in northern California, and her passion for health IT took off when she worked with Dr. David Brailer on a pioneering RHIO in Santa Barbara County, Calif., and later in the Office of the National Coordinator for Health IT.
While serving as vice president of the eHealth Initiative, she spearheaded the nonprofit organization’s launch of the Connecting Communities for Better Health program.
Looking back on the past decade, Evans said she’s amazed by the amount of progress the country has made on health IT. “We may be still struggling as a country about how to do this exactly, but the way that we have organized ourselves and prioritized this is quite compelling,” she said.
Her framework for using IT to change health care delivery in New York rests on three building blocks: a Statewide Health Information Network for New York (SHIN-NY), the adoption of interoperable electronic health record systems to help coordinate care, and new tools for ensuring quality and boosting population health, such as clinical decision support and performance metrics.
None of those components works well without the others, she said, and they should be developed simultaneously. For example, “if we just did the SHIN-NY, that’s the highway, but we’re adding the other pieces that are the cars and the fuel lines. You need all of those pieces to realize value.”
A public/private partnership called the New York eHealth Collaborative enables the government to work with hospitals, doctors, patients, health plans and other stakeholders to develop mutually acceptable policies and shared approaches — “and also to ensure that health IT grows up in the public interest,” Evans said.
Heavy-handed government regulation is not the right approach, she said. “We don’t have the answers yet,” she added. “We may have a lot of unintended consequences if we want to regulate this in a vacuum.”
On the other hand, if the RHIOs make their own decisions, she said, “then we’ll end up with silos across the state.” The state government would become involved in some
areas, such as privacy and interoperability, because of the need to enforce state laws and ensure a return on the public’s investment.
“States really have the implementation role in all this,” Evans said.
The opportunity to lead implementation rather than be limited to an advisory or policy-making role was one reason she took the job, she said. She was also excited about the team she would work with.
Furthermore, “the funds that are available in New York were very compelling,” she said. “There’s a lot of investment to be made, and that’s a huge opportunity to make a difference in the lives of New Yorkers and also to make a difference in helping inform how the country advances when it comes to health IT.”
Beyond the $158 million already disbursed in grants, Evans said she expects to have another $50 million to $100 million to distribute in the future.
“That’s not happening anywhere else across the country — at the federal level or at the state level,” 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.
