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July was the best of times and the worst of times for state-managed health information exchanges (HIEs). While Pennsylvania took a major step toward establishing its own statewide exchange, Tennessee closed the HIE that it established 3 years ago.
Pennsylvania Governor Tom Corbett signed legislation on July 7 that established a framework for the Pennsylvania eHealth Partnership Authority. The authority will oversee the development of the state’s first statewide HIE. Pennsylvania's HIE will be a decentralized, "thin layer" communications system, according to the Pittsburgh Post-Gazette. This means that the HIE will help facilitate connections between the state's regional, privately owned health information networks. An "opt-out" provision will allow patients who sign a non-consent form to decline participation.The authority’s board will have 15 members, including representatives of government agencies, a hospital, an insurance company and the health information technology industry. Significantly, the board will also include a representative of the assisted living and long-term care field, a representative of "under-served" rural or urban health care communities, and two consumers.
The Tennessee Office of eHealth Initiatives received $11 million from the 2009 federal economic stimulus package to develop the Health Information Partnership for Tennessee (HIP TN). That HIE officially announced its closure on July 9.
Although HIP TN conducted tests and demonstrations of health data exchange among communities, it never actually helped exchange clinical data, according to iHealthBeat.The HIP TN board voted to shut down the HIE because it believed the exchange “was ahead of the game and somewhat premature,” says Will Rice, executive director of Tennessee’s Office of eHealth Initiatives. However, Rice offered assurances his state is not turning its back on data exchange. Moving forward, Tennessee plans to focus its efforts on helping the state’s health care providers meet the requirements of the Medicare and Medicaid electronic health record (EHR) incentive programs. In that effort, the state will use its remaining stimulus funds to promote education and awareness about the use of the federal Direct Project as a vehicle for health data exchange.
The Direct Project is a public-private consortium that offers a secure messaging protocol for exchanging clinical messages among trusted parties. According to FierceHealthIT, a number of statewide and regional HIEs have embraced Direct’s Internet-based messaging as a way to jump-start online information exchanges among providers that do not yet use EHRs.
The Office of the National Coordinator for HIT (ONC), which helped launch the Direct Project, announced recently that almost 30 states are using the Direct Project. According to ONC, 7 states have already signed up 300 or more providers for Direct: