Wednesday, August 26, 2009

Iowa e-Health Project on Track

Iowa’s Health Information Technology Plan recently published defines the state’s vision for the Iowa e-Health project. The Electronic Health Information Executive Committee and Advisory Council and the Iowa Department of Public Health submitted the report with detailed information on the project.

Although Iowa is not yet currently engaged in a statewide HIE, so far, many health IT milestones have been accomplished. According to the report, Iowa has developed HealthNet connect (HNc) a 3,200 mile fiber optic network. Funds for $7.8 million were made available from the FCC in their Rural Health Care Pilot Program to provide for last mile connections so that nonprofit hospitals can link to HealthNet connect.

Today, the HNc backbone network runs throughout Iowa and spans four states, with direct fiber connections to major metropolitan cities stretching from Denver to Chicago. Additionally, the HNc backbone connects to Internet2 and National Lambda Rail networks.

The Iowa Hospital Association also received grant funding for three years from the FCC in 2008 to link 80 hospital facilities through the state-owned Iowa Communications Network. ICN has provided inter-hospital broadband networking for 23 years and will use the funds to provide the network capacity to extend services to rural hospitals and the communities they serve.

In 2008, seven North Iowa hospitals, integrated an electronic health record system, the first of its kind in a rural healthcare setting. The initiative was supported by two grants from AHRQ, and in addition, the Mercy Health Network-North Iowa, seven rural facilities, local public health agencies, Trinity Health, and the University of Iowa, College of Public Health worked to implement the EHR system.

Iowa has also participated in HISPC, to address privacy and security challenges. The project led by the Iowa foundation for Medical Care and a multi-stakeholder steering committee, studied privacy and security barriers, formed urban and rural consumer focus groups, developed a patient consent framework for treatment scenarios, participated in a continuity of care document exchange pilot, discussed legal and legislative issues, and developed a model for data sharing agreements.

In January 2009 the first meeting of the Electronic Health Information Executive Committee and Advisory Council met. At that time, several workgroups were established to promote the adoption and use of health IT in Iowa. These groups looked at HIEs, privacy and security, provider adoption of EHRs, workforce and education issues, patient identify concerns, and the types of clinical data to be exchanged using the HIE governance.

The Committee discussed the significant start-up and ongoing funding needs. Some of the largest expenses include hardware, software, technical support, legal expertise to safeguard privacy and security, technical project management support for pilot projects, and resources for the overall management and coordination of activities.

Some of the states will receive financial support from their state government for startup costs and ARRA is expected to provide federal financial support. However, this still means that the states will be required to match $1 for each $10 of federal funds in 2011, $1 for each $7 in 2012 and $1 of state match for each $3 for federal funds in 2013 and beyond.

So far, the workgroups and stakeholder organizations have worked together and in the coming year, IDPH and the Electronic Health Information Executive Committee and Advisory Council plan to support additional workgroup meetings to further define and execute project activities, determine cost requirements, and then pursue federal and state grant programs to secure the funding needed for the projects.

To see the full report, go to