As part of federally mandated health-care reform, a number of states are  developing online systems that will give physicians and clinicians the ability to electronically move patient health records across disparate platforms. But are these health information exchanges (HIE) being built to flourish?

For those governments in the midst of the establishing an HIE, a new report offering guidance on best practices and sustainability may be just what the doctor ordered to ensure the HIEs meet customer needs and federal guidelines.

Sustainable Success: State CIOs and Health Information Exchange, published Tuesday, Sept. 20, provides CIOs and policymakers ideas for creating revenue streams, considerations for systems development and options for reducing maintenance and lowering costs.

Released by the National Association of State Chief Information Officers (NASCIO), the 10-page document also focuses on expense calculation, usage fee models and encourages states to reference an eight-phase toolkit from the eHealth Initiative when building an HIE.

“There are substantial federal incentives for public and private organizations to develop interoperable health information exchanges, but what is going to set a successful HIE apart is the ability to provide innovative services with minimal costs,” said Doug Robinson, executive director of NASCIO, in a statement. “State CIOs recognize there is no better time than now for carrying out these goals, but continued ingenuity will be vital to ensure a state-run HIE is independently sustainable and fully operational.”

In an e-mail to Government Technology, Chad Grant, NASCIO senior policy analyst and the lead on compiling the issue brief’s material, said that it was difficult to address all contingencies regarding HIEs because each state has a unique governance structure.

In most instances, state CIOs will likely serve in more of an advisory role regarding HIEs, Grant said. One of the key suggestions that came out of the issue brief was that policy officials look into cloud-based solutions.

“The health information from states will need to be secure and, because of the vast amount of data, have the ability to scale quickly,” Grant explained. “State CIOs are already adopting cloud service models in state government and HIE is another area that should be explored.”

He added that one of the most overlooked aspects of creating an HIE is a shift in attitude toward enterprise IT solutions and how federal funding guidelines could create savings for both the states and Uncle Sam.

“With proper braided funding guidelines, states could eliminate redundancies and ‘stovepiped’ systems, which could lead to cost controls — and ease budget burdens that states are currently facing,” Grant said.

Brian Heaton  |  Senior Writer

Brian Heaton is a senior writer for Government Technology. He primarily covers technology legislation and IT policy issues. Brian started his journalism career in 1999, covering sports and fitness for two trade publications based in Long Island, N.Y. He's also a member of the Professional Bowlers Association, and competes in regional tournaments throughout Northern California and Nevada.