At INPUT's State & Local MarketView Conference yesterday, I presented on the states' progress toward Health IT implementation, discussed a timeline for a "tipping point" -- when spending on Health IT would really take off, and my "big bang" theory, which is when will politicians start talking about Health IT AND Medicaid together, not separately. This blog reprises the portion of the presentation that identifies where each state is along the implementation roadmap.

This year 27% of the governor's who gave state of the state speeches proposed a variety of Health IT initiatives -- up from 14% in 2007. These initiatives were primarily in the areas of electronic medical records (EMR), transparency web sites, health information exchanges (HIE), and electronic prescribing. Governors have issued 15 Executive Orders related to health IT in 2007 and so far this year.

A review of governors' recommended budgets for 2009 identified nearly $55 million for Health IT projects. Keep in mind, the detail in budget documents vary wildly from state to state and often IT projects are "buried" in the overall program budget so this number is quite likely to be low.

In addition to the states' chief executives, state legislatures have been very active on the Health IT front. In 2007, according to the National Conference of State Legislatures (NCSL), 63 bills in 36 states were introduced and 59 bills in 35 states were passed. So far this year, 76 bills have been introduced in 36 states with 12 bills in 9 states being enacted.

Source: NCSL and INPUT

NCSL reports that beyond HIEs, EMRs, electronic health records (EHR), and personal health records (PHR) there is little consensus about how to define Health IT. States disagree about the inclusion or exclusion of telemedicine, biosurveillance, or Medicaid Management Information Systems (MMIS).

eHealth Initiative has developed a progress framework that may be familiar to many of you who regularly attend Health IT events. INPUT's health care analysts have reviewed a variety of state documents and attended countless events about Health IT. The following table identifies where each state is in their progress towards statewide implementation:

It's important to note some distinctions. Tennessee started off regionally, investing $10 million in three Regional Health Information Organizations (RHIO). They conducted county assessments and a legal review of the barriers to Health IT adoption. They have several telehealth, e-prescribing and broadband initiatives underway, too. With the governor's backing, these efforts have been "baked" into the statewide plan and are the first steps forward in moving the whole state forward in its implementation. In contrast, another state known to be progressive in the area of Health IT is Indiana. The Indiana Health Information Exchange (IHIE) is not a governmental entity and is stake-holder governed with little state involvement. So while both are quite advanced -- Tennessee is doing it as a state and the IHIE is doing it for their state.

If you missed this year's MarketView, you might want to check out some of our other upcoming state and local events:

• State Executive Webinar featuring John P. Gillispie, Chief Information Officer, State of Iowa
• INPUT and ITAA's State Executive Seminar featuring California's Top Technology Leaders

Watch our events calendar for information about next year's State & Local MarketView.