The new report “Public Governance Models for a Sustainable Health Information Exchange Industry” prepared for the State Alliance for e-Health, assesses the current state of the HIE marketplace and the government’s role. According to John Thomasian, Director of the National Governors Association Center for Best Practices, this report serves as a valuable starting point for states as they consider governance strategies for building, sustaining, and protecting a system to support electronic health records.
The report discusses the significant burden of healthcare costs on state budgets, the imperative to improve the quality of healthcare delivery, and the likelihood of accelerated investments being made in HIT. There is a critical need for state leaders to keep informed of the key issues involved and the strategies needed to effectively leverage investments in technologies for health system improvements.
To compile the report, interviews were conducted with operating health information organizations. The results indicated that key public and private healthcare stakeholders must be engaged and represented by an organized governance structure and there needs to be a technical architecture to facilitate electronic HIEs. Also, data sources, transaction types, and standards need to be identified, along with addressing the financing of HIEs.
The report outlines three conceptual governance models:
- Model 1—Government-Led Electronic HIE
- Model 2—Electronic HIE Public Utility with Strong Government Oversight
- Model 3—Private-Sector-Led Electronic HIE with Government Collaboration
These conceptual models can be used as a starting point for states to use when considering viable oversight strategies. This is based on the level of regulatory control state governments wish to exert over the electronic HIE industry. The body of the report provides more specific rationale and description, details on the legal structure needed, plus financing and accountability considerations are given for each model.