State Trends and Issues:

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State Trends and Issues Health Information
Technology Beyond the Beltway State Local
Government IT Market Watch McLean, VA March 31,
2008 Chris Muir Senior Program Analyst Office
of the National Coordinator for
Health Information Technology
(ONC)
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Making the Case for Health Information Technology

• In 2000, the Institute of Medicine estimated that
  up to 98,000 Americans die each year from
  preventable medical errors.1
• Medical errors are killing more people per year,
  in the U.S., than breast cancer, AIDS, or motor
  vehicle accidents.2
• 80 percent of errors were initiated by
  miscommunication. 3
• 2007 - Total U.S. health care spending
  represented 16 of the GDP 4
• Health expenditures increase about two times the
  rate of inflation
• Total spending was 2.3 TRILLION or 7,600 per
  person
• 2015 U.S. health care spending expected to be
  4.2 TRILLION or 20 of GDP 5

In attempting to arrive at the truth, I have
applied everywhere for information, but in
scarcely an instance have I been able to obtain
hospital records fit for any purpose of
comparison. They would show subscribers how their
money was being spent, what amount of good was
really being done with it, or whether the money
was not doing mischief rather than
good. Florence Nightingale, 1873
1 Kohn, L., J. Corrigan, and M. Donaldson. To
Err Is Human Building a Safer Health System.
Committee of Health Care in America, Institute of
Medicine. 2000. 2 Institute of Medicine and
Centers for Disease Control and Prevention.
National Center for Health Statistics
Preliminary Data for 1998 and 1999. 2000. 3Smith,
Peter, et. al. Missing Clinical Information
During Primary Care Visits, The Journal of the
American Medical Association. February 2005. 45
National Coalition on Health Care, Facts About
Health Care - http//www.nchc.org/facts/cost.shtml

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Why do State Governments Care about HIT?

• Employer with substantial numbers of covered
  lives including retirees and dependents
• Medicaid programs
• Public health responsibilities
• Health care provider (e.g., state hospitals,
  etc.)
• Health care regulatory responsibilities
• Protecting and improving health for citizens
• Competitive for economic growth
• Federal dollars available

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Transforming Health Care Moving from Treating
to Preventing to Predicting1
BIRTH
Injury and Acute Illness
Family History Genetics
Environmental Exposures
Death
Chronic Illness
Lifestyle
Intervene
Predict Prevent
Manage
1. Adapted from Perlin, Dr. Jonathan B,
Healthcare 2015 beyond Some Thoughts on
Planning Ahead, p. 95
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Key Health IT Components to Enable Transformation
A Robust, Interoperable, Health IT Environment
that Brings Together

• Electronic Health Records (EHR)
• Personal Health Records (PHR)
• Population Health Information (Public
  Health, Quality Improvement, Research)
• Interoperable Health Information Exchange Network
• (Nationwide Health Information Network - NHIN)

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State Involvement in HIT

• Governors in 18 states released executive orders
  about HIT (with about half during the last 12
  months)
• In 2007, 208 bills introduced in 50 states for
  the adoption or implementation of health IT with
  30 being signed into law in 19 states
• ¾ of state governments involved in state health
  information exchange efforts
• Telehealth programs continue to grow
• Federal investments continue to driveUSDA (22
  million) and F.C.C. (400 million)
• At least nine states are involved in EHR/EMR
  projects
• Seven states have e-Prescribe programs and many
  others are exploring
• With HHS activities and Congressional
  legislation, this is sure to increase
• DEA is in process of changing requirements and
  allow controlled drugs to be dispensed using
  e-Prescribe thus increasing demand

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Questions Comments
www.hhs.gov/healthit