State policy makers taking action to drive improvements in healthcare quality and safety through information technology

Governors and state legislators launching commissions to develop roadmaps for healthcare change

WASHINGTON, Aug. 16, 2006 -- A majority of states are taking critical steps to drive improvements in the quality, safety and efficiency of healthcare through information technology. An issue brief released today by the independent, non-profit eHealth Initiative (eHI) notes that 38 state legislatures have introduced 121 bills during 2005 and 2006 that specifically call for the use of health information technology (HIT) to improve patient care -- over half of which were introduced in the first seven months of 2006. Thirty-six bills passed in 24 states and were signed into law during 2005 and 2006. The eHI report also indicates that 10 executive orders were issued by U.S. governors across the nation, calling for the development of strategies, plans and recommendations for using HIT and health information exchange to improve health and healthcare.

The issue brief, "States Getting Connected: State Policy Makers Drive Improvements in Healthcare Quality and Safety Through Information Technology," traces a significant increase in engagement among key state leaders in the arena of health information technology and quality. The report is available at

"There is a notable increase in activity at the state level, reflecting a parallel increase in recognition at the federal level of the importance of IT in moving towards a more patient-centered, higher quality healthcare system," said Janet Marchibroda, eHI's chief executive officer. "This issue brief is a direct examination of the significant leadership role that governors and state legislatures alike are playing in engaging local public and private sector leaders to lay the information infrastructure required for a higher quality, safer, and more cost-effective healthcare system."

The report, which was developed by eHI with legislative tracking support from Davis, Wright, Tremaine, LLP, identifies and analyzes legislation introduced by the states during 2005 and 2006.

Key findings include the following:

-- HIT State Legislative Activity Is on the Rise. State legislatures are increasingly recognizing the importance of information technology in driving health and healthcare improvements, with 38 state legislatures having introduced 121 bills in 2005 and 2006 which specifically focus on HIT. And states are not only introducing legislation; many bills are being signed into law. In 2005 and 2006, 36 bills were passed in 24 state legislatures and signed into law.

-- U.S. Governors Driving Change at the State Level. As of this writing, 10 executive orders were issued by U.S. governors across the nation calling for the development of strategies, plans and recommendations for using HIT and health information exchange to improve health and healthcare.

-- Primary Focus of State Policy Is on Creation of Commissions to Develop Recommendations and Plans for HIT. Fifty-three bills emerging from 25 states during 2005 and 2006 call for the creation of bodies such as commissions, councils or task forces to conduct studies, recommend actions, and develop strategies and plans for improving healthcare through HIT. Nineteen of these bills passed in 14 states during this period.

-- State-Driven Healthcare Reform Efforts Are Integrating HIT into their Strategies: Increasingly, States Are Building Quality into HIT Planning Activities. Increasingly, state legislators are not only calling for the integration of quality goals into HIT-related plans and requirements for state-funded HIT initiatives and programs, but they are also building HIT into their state-driven health reform plans. During 2005 and 2006, 12 HIT-related bills introduced in nine states referenced quality specifically, with five such bills passing in four states.

-- Number of States Providing Funding Support Is Increasing. Fifteen bills were introduced in 11 states which call for the incorporation of financing strategies into newly-legislated state HIT plans, such as loan or grant programs, with seven bills in six states passing. Twenty-seven bills were introduced in 16 states during the same time period which call for the authorization or appropriation of funding for HIT or health information exchange-related activities. Eight such bills passed in seven states and became law.

-- Driving Change Through Target-Setting: States Calling for Action. Three states have introduced legislation which set target dates for provider adoption of HIT within the state, two of which passed.

"We found that most proposed legislation and executive orders emphasized the potential for HIT to both reduce costs and significantly improve the quality and safety of healthcare," said Emily Welebob, eHI's senior vice president, programs. "Those goals align with eHI's mission as we work with state, regional and community stakeholder groups to drive improvement in healthcare through the use of HIT."

The August report serves as a follow-up to eHI's July 2006 Issue Brief which highlighted state level findings from eHI's 2006 annual survey of state, regional and community-based collaborative initiatives and organizations. According to the July report, 35 states are either planning or implementing HIT-related efforts, with quality, safety and rising healthcare costs ranking highest as the primary drivers for state leadership around HIT. Go to iti es.pdf for a copy of the July 2006 report.

Since 2004, eHI has been providing leadership and support to states, regions and communities who are improving health and healthcare through HIT and health information exchange. In its work over the years at both the national and local levels, eHI has developed resources and tools designed to support the many stakeholders in this effort to navigate the organizational, legal, financial, clinical and technical aspects of health information exchange. Go to for eHI's Connecting Communities Toolkit.

About eHealth Initiative and its Foundation

The eHealth Initiative and its Foundation are independent, non-profit affiliated organizations whose missions are the same: to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology.

eHI engages multiple stakeholders, including clinicians, consumer and patient groups, employers, health plans, healthcare IT suppliers, hospitals and other providers, laboratories, pharmaceutical and medical device manufacturers, pharmacies, public health, and public sector agencies, as well as its growing coalition of more than 280 state, regional and community-based collaboratives focused on improving healthcare by mobilizing health information electronically, to develop and disseminate common principles, policies and best practices for improving the quality, safety and effectiveness of America's healthcare through information and information technology.

For more information, go to

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