Wednesday, February 8, 2012

Brookings Institute- Governance Paper: Health Exchanges and Megachange

In this paper, we analyze state health information exchanges (HIEs) as an example of what MITRE researcher John Piescik calls “megachange” challenges.[ii] According to the U.S. Department of Health and Human Services, HIEs are “efforts to rapidly build capacity for exchanging health information across the health care system both within and across states.”[iii] This includes insurance information for those without coverage and clinical and medical data in order to connect health care providers and payers. The goals are to increase the flow of information across relevant organizations and improve the efficiency and effectiveness of the health care system.

These organizational innovations are an interesting example of policy change in a big and complex area. Health care represents nearly one-sixth of the overall economy and has costs that are growing well beyond the inflation rate. There are multiple actors such as patients, physicians, hospitals, vendors, payers, and advocacy organizations that are important to health care. It generally has been difficult to forge policy agreements among the various constituencies who are involved in this domain.

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Briefly, we find that state health information exchanges have made progress in establishing organizational frameworks, building technology-based connections, and bringing relevant groups to the table for discussion. However, barriers remain in terms of governance, financing, and policy vision. Many states and localities have experienced difficulties in producing consensus on strategies and approaches, and identifying consistent revenue streams. Some question whether the state level is the proper unit for HIEs given natural marketplaces centering on localities or regions. Until those problems are overcome, it will be impossible for HIEs to achieve their full potential.


Hat tip: Brookings Institute: Summary with link to full paper

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