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The eHealth Initiative (eHI) is an independent, nonprofit organization that engages the multiple stakeholders in health care both at the national level, and within states and communities across the country, to develop and drive the implementation of a common set of principles, policies, and best practices for improving the quality, safety, and efficiency of health care through information and information technology (IT).
Congress, state leaders, and many members of the private sector have taken action to increase the use of HIT in health care. A number of states are also moving forward—in parallel with federal efforts—to develop and adopt policies for improving health and health care through HIT and electronic health information exchange. State legislators are increasingly recognizing the role of HIT in addressing healthcare challenges, with 121 bills introduced in 38 states since 2005. Thirty-six such bills in 24 states were passed in the legislature and signed into law.1 State legislatures are not the only policymakers driving change in states—US governors are increasingly recognizing the value of HIT in addressing their health care goals. To date, 14 US governors have issued an executive order designed to drive improvements in health and health care through the use of IT.2
In September 2006, eHI released the results of its Third Annual Survey of Health Information Exchange at the state, regional, and community levels, analyzing results from 165 responses from initiatives in 49 states, the District of Columbia, and Puerto Rico.
According to eHI's survey results, 47% of the 165 respondents identified themselves as being in the advanced stage of development, with 26 of such initiatives identifying themselves as “fully operational.” Survey results indicate an increasing level of maturity in the functionality of these health information exchange efforts, with at least one fifth of all initiatives now electronically transmitting claims, dictation, emergency department episodes, enrollment/eligibility, inpatient and outpatient episodes, laboratory results, and radiology results.3
Survey results also indicate that the most common functionalities of such efforts are those related to care delivery, with more than one fifth of respondents offering the following services: clinical documentation (26%), results delivery (25%), consultation/referral (24%), electronic referral processing (23%), and alerts to providers (20%).4 In addition, such efforts are continuing to expand services provided to support improvements in the quality and effectiveness of health care. Twenty percent of all respondents are currently providing disease or chronic care management services. Eleven percent of respondents are providing quality performance reporting for purchasers or payers, while 10% are providing quality performance reporting for clinicians.5
Clinicians play one of the most critical roles in the transformation of the US health care system. Most of the United States' health care is delivered by practicing physicians, and research conducted by the eHI Foundation indicates that patients trust clinicians the most to deliver information to them about secure health information exchange with 67% of respondents identifying physicians as a trusted source.6
eHI recognizes the important role of clinicians through the significant involvement of several medical associations and societies in its membership and leadership as well as its many programs and initiatives at both the national and local levels. eHI also believes that getting to a higher quality health care system requires strong collaboration among all of the multiple stakeholders in health care, including clinicians, employers, health plans, hospitals, government agencies, and consumers. eHI's Connecting Communities Coalition—now representing more than 250 state, regional, and community-based organizations—is designed to build bridges between national multistakeholder efforts and leadership efforts in the field.
eHI looks forward to building a stronger bridge with the cancer community—both at the national and local levels, to develop commonly shared principles, strategies, and best practices for the use of HIT to support shared goals around prevention, detection, treatment, and ongoing support in cancer care.