The health information exchange (HIE) arena exploded in 2009, with stimulus funding for electronic health records and HIEs. The American Recovery and Reinvestment Act (ARRA) of 2009 provided approximately $150 billion in health care funding, including $564 million under the Health Information Technology for Economic and Clinical Health Act (HITECH). States were granted one award, ranging from $4 million to $40 million per state. The State HIE Cooperative Agreement Program funded states' efforts to rapidly build capacity for exchanging health information across the health care system.
In 2010, we saw 27 states release a request for proposals (RFP) or award a contract for their HIE.
As of today, the map is mostly red, with only Kansas and New Jersey still working on an RFP.
The following chart is a list of state HIE vendors with awarded or ongoing contracts. (It should be noted that this list is not inclusive, but represents a survey of prevalent vendors and example states with a contract award.)
Core components of most state HIEs include:
- Master patient index (MPI), which utilizes a standard identity/information correlation process to uniquely identify an individual and match patient data from different providers and care settings.
- Record locator service (RLS), which coordinates with the MPI and facilitates the exchange of secure messages and documents, but does not store information contained in the records.
- Authentication services, which are state-mandated security controls that identify who can access the statewide HIE.
- Access and authorization services, or role-based security, that controls how an individual is permitted to use the statewide HIE.
- Auditing and logging services
- Transport and content standards, which include nationally-recognized specifications and protocols to enable communication among different health data systems.
- Data transaction services, which include the processes and software necessary to facilitate the exchange of various types of data through the statewide HIE.
- User and system interface (methods to access the statewide HIE)
Although it may seem that the health insurance exchange (HIX) market has dominated news across the country, behind the scenes, HIEs are still large works in progress. The components above, and others necessary to operate exchanges, will need continued operation, maintenance, and potential enhancements to remain effective and functional. As with HIXs, sustainability is also a key concern as federal funding runs out. It should be interesting to watch the successes (and possible failures) of statewide HIE implementations, and how well citizens adopt and interact with their medical records.