Because many health IT projects and health information exchanges are under way at various government levels -- many of them funded at least in part by the economic stimulus -- it can be overwhelming to encapsulate how these ventures are related and what people and organizations are in charge of them.

The National Association of State Chief Information Officers (NASCIO) seeks to give clarity on this complex topic with a state-by-state look at health IT programs and leadership in a report released Thursday, July 29, called Profiles of Progress 4: State Health IT Initiative.

The report is available for free download.

The association said since the last version of the report released in 2009, there's been "a tremendous flurry of activity due to the Office of the National Coordinator for Health Information Technology announcing the recipients of the State Health Information Exchange [HIE] Cooperative Agreement Program." Stimulus funding also is beginning to flow to state and regional projects, according to NASCIO.

The report takes a state-by-state look at major initiatives, state government involvement and who's in charge.

The state CIO's role in health information exchange depends on how involved the state is in the design's exchange, according to NASCIO. "If public expectations are high for strong government presence it will most likely be a government-led electronic health information exchange. On the other hand, if a state chooses to be less involved in overseeing the HIE and determining the business model, it can let other actors, such as a nonprofit entity created by stakeholders, operate the HIE."

"State CIOs and government leaders recognize the importance of state-driven health IT efforts," said Doug Robinson, NASCIO executive director, in a prepared statement. "They value the critical role of states in planning and implementing a secure, efficient and interoperable health information exchange."