ARRA funding includes $564 million to use for HIT planning and implementation activities conducted by the states. The Federal government has announced that it is distributing these funds through the “State Health Information Exchange Cooperative Agreement Program.” Each state will receive between $4 million and $40 million based on a formula.
Originally, planning began in January 2008, when the state of New Jersey created a HIT Commission to identify short-term priorities and long term goals to establish HIT in the state. The Commission brought together a broad base of stakeholders from across the healthcare industry to include clinical professionals, healthcare executives, health information technology experts, and several departments of state government.
The same legislation created the Office of e-HIT in the Department of Banking and Insurance. This resulted in the Commission and the Office of e-HIT working closely together to develop a state plan for electronic health records and health information exchanges.
According to a study conducted by Avalere with grant funding from the Robert Wood Johnson Foundation and Horizon Blue Cross/Blue Shield, there are several key findings that needed to be considered by the state when planning for HIT.
First of all, the state has higher than average hospital bed capacity and higher than average rates of hospital admissions, some hospitals are in relatively poor and declining financial conditions, there is a need for cost avoidance strategies, measuring quality is an issue, plus accessible measures are needed to assess the quality and efficiency of services provided in the state.
In addition, the physician community is fragmented and tends to be organized into solo or small group practices with little impact from the growth of managed care plans over the past ten years. There appears to be limited efforts at integration into larger groups specifically in areas of northern New Jersey.
The study found that the state is a net exporter of healthcare resources. This means that a higher percentage of New Jersey residents seek care from out-of-state providers compared to the number of out-of-state residents who travel to New Jersey for care. This has implications concerning the exchange of health information across health institutions and across state lines.
The “New Jersey Plan for Health Information Technology” recently finalized supports Medicaid funding for electronic medical records, supports Regional Extension Centers created under ARRA, supports Electronic Medical Records in physician practices, seeks broadband expansion, mandates the interoperability and expansion of community HIEs.
The state is supporting local and regional coalitions of medical providers through Health Information Exchanges with federal grants that will be administered by the state Department of Health and Senior Services. In August 2009, the state released a Request for Applications seeking regional health information exchange projects and accepted applications September 2009, and by October, the state began to seek funding from the federal government.