HEAL NY: Promoting Interoperable Health Information Technology In New York State

Abstract

Through a novel, ambitious program called HEAL NY, New York State plans to invest $250 million in health information technology (IT) that can be linked electronically to other health IT systems. In contrast to high rates of closure by other organizations attempting health information exchange (HIE), 100 percent of HEAL NY Phase 1 grantees still existed two years after awards were announced, 85 percent were still pursuing HIE, and 35 percent had actual users. The number of grantees meeting basic criteria for regional health information organizations (RHIOs) increased. Although it is early, lessons learned can inform state-based initiatives nationwide. [Health Affairs 28, no. 2 (2009) 1 Health information exchange is defined as "the electronic movement of health-related information among organizations." 2 Regional health information organizations (RHIOs) have been proposed as a model for changing health care delivery at local and regional levels through HIE. 3RHIOs bring together multiple stakeholders, including physician practices, hospitals, pharmacies, and laboratories, for the purpose of exchanging clinical information electronically. By doing so, RHIOs have the potential to integrate otherwise fragmented health care, improve quality, and decrease costs.

How could health information exchange better meet the needs of care practitioners?

“…However, that approach may have reached its limits of effectiveness, or at least may be in a period of diminishing returns. Users in this study wanted more providers participating, but that is within the context of numerous forces that should increase participation: providers generally wanting the information made available by HIE systems [44], extensive state and federal funding for practices to implement EHRs [9,45], Meaningful Use criteria that require exchange capabilities [46], and (at least in New York) RHIOs that have been operational for multiple years. Currently, providers have multiple options to meet Meaningful Use requirements that do not require the on-going exchange of data with a wide-variety of community providers as in the RHIO model.…”

The potential for community-based health information exchange systems to reduce hospital readmissions

“…This study was part of a broader evaluation of the Capital Grants program of New York State's Healthcare Efficiency and Affordability Law for New Yorkers (HEAL NY), which was passed in 2004 to establish a statewide electronic health information infrastructure for healthcare system transformation and is the largest state-based public investment to promote HIE development and electronic health record adoption. 21 …”

“…Data were accessed via the Rochester Regional Health Information Organization (RHIO), a non-profit, community-run, data management organization that facilitates secure HIE access for authorized clinicians. 21,22 RHIO information exchanged via a web-based portal includes discharge summaries, diagnoses, radiology reports and images, medication history, and payer information. 23 More than two-thirds of the region's 24 hospitals and physicians currently participate.…”

Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

“…3 Thus, it is possible that the HITECH Act may have accelerated the existing trend in physician adoption, in addition to being influenced by market forces, state health information technology (IT) initiatives, and health care delivery and payment reform mechanisms which involve the use of EHRs. 2,16,17 Some of these forces driving EHR adoption may affect primary care physicians in particular. An examination of trends prior to 2007 indicates that primary care adoption rates were lower than specialists.…”