States move to use IT to drive improvements in healthcare quality and safety

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A majority of states are taking critical steps to drive improvements in the quality, safety and efficiency of healthcare through information technology. The non-profit eHealth Initiative (eHI) published a report stating 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.
“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.
A primary focus of state policy is the 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 as well as quality initiatives into their strategies. 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 also are 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.
The 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.
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.
The report is available at