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Assessing Health Information Technology in Ohio
(Briefing Paper for the 2005 Ohio Health Information Symposium)


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(October 2005, pdf format, 1.8 MB)
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Consensus has emerged among leaders in both the public and private sectors that Health Information Technology (HIT) and Health Information Exchange (HIE) play a key role in addressing the mounting challenges facing our nation’s health care system. The Institute of Medicine (IOM), some of the nation’s largest employers, provider and physician groups, members of Congress, nearly every federal government health care agency, a growing group of governors, and President Bush all have called for investment in electronic health records and HIT.

Despite evidence that information technology improves the quality, safety and efficiency of patient care, our nation’s health care industry lags far behind other industries in information technology (IT) investments. The reasons for this lag consist of:

• a lack of standards adoption necessary to create interoperability across systems;
• complex organizational and clinical process change requirements;
• privacy and confidentiality concerns; and
• the lack of financial incentives for using HIT.

Interoperability is one of the most difficult problems facing the creation of a national IT infrastructure for exchanging health data. Among current IT investments, interoperability is a 21st-century health care system requirement that can transform the current health care system by decreasing health delivery costs; ensuring that patients have access to the highest quality, most efficient, and safest care; and ensuring that providers have access to a longitudinal electronic health record. And in light of recent natural disasters and bioterrorist events, the need for interoperability has become heightened to ensure that systems can communicate with emergency workers during disasters.

National health care leaders in both the public and private sectors are beginning to tackle these barriers through a growing number of diverse initiatives at the federal, state and local levels. At the local level, over 100 nascent or operating health information organizations or initiatives in nearly every state of the nation are emerging to tackle a wide range of issues. Many projects are focused on developing a health information infrastructure to deliver clinical results and information to practicing clinicians and other providers at the point of care. Others are seeking to facilitate patient-provider communication, eligibility and enrollment checking, and the use of data for reminders or consultations. The key themes heard throughout the country are the need for national standards, the need for interoperability, the need for incentives to adopt HIT, and the need for private-public sector collaboration.

The interest of Ohio’s leaders in HIT and HIE is reflected in various local HIT and exchange efforts across the state. There have been various sponsors of HIT and exchange conferences held throughout the state to inform and raise awareness of participants about national and local HIT efforts, provide opportunities for networking, and inspire state champions to become advocates for health care transformation by HIT. Ohio is home to nationally-recognized and award-winning HIT initiatives within large hospital systems and academic settings, as well as HIE initiatives.

Interviews with over thirty Ohio state leaders confirm that HIT is increasingly viewed as an important tool to address the health care challenges facing the state. High health care costs and the need to improve quality outcomes are contributing to a sense of urgency in Ohio and many health care leaders see a window of opportunity to seek real and needed change in Ohio’s health care system. Yet, most believe that the issue has yet to mature as a policy priority in the state. Interview participants viewed financing as the main barrier to progress demonstrated by a low HIT adoption rate for physician offices. Competition is also a common concern, and some are skeptical that competitive market forces will allow broad scale opportunities for HIE. Rural health care delivery is also a challenge to “wire,” but some expressed that rural environments may have less organizational obstacles and should be the priority. Overall, the leaders interviewed are willing to participate in efforts to establish information exchange organizations within their local communities. Most express a desire to communicate across regional projects, as appropriate, and to devise a broader vision for HIT adoption and HIE in Ohio.

In the coming months, as Ohio witnesses the continued evolution of national events, as well as developments within the state, it is important to begin to lay a foundation to enhance HIT adoption and the creation of HIE initiatives. The pressures on the system are inevitably going to force change. The 2005 Ohio Health Information Symposium on October 17, 2005, in Columbus, Ohio, involves multiple and diverse health care leaders and stakeholders in Ohio. The symposium presents a timely opportunity to begin to develop a shared vision and plan for addressing health care challenges through information technology and health information networks to improve access and health care delivery for the people of Ohio.

For more on the 2005 Ohio Health Information Symposium, go here.