The State Alliance for e-Health Meeting (State Alliance) took place on February 19, 2010 in Washington DC. The State Alliance was created in January 2007 by the National Governors Association Center for Best Practices as a way for states to come together and discuss ways to improve the nation's health care system. The primary goal of the State Alliance meetings is to increase the efficiency and effectiveness of health information technology (HIT) initiatives as they develop. The meetings consist of various stakeholders sharing and exploring solutions to programmatic and legal issues related to health information exchange (HIE).

The main focus of the conference revolved around ways to improve the adoption of HIT and operations states' should be taking in order to jumpstart the process in an efficient manner.

The meeting consisted of five sessions where representatives from various departments and states facilitated discussion of various areas including:

• HIE
• Using collaboration as a tool
• Building critical infrastructure
• Sustainability
• Future activities for the State Alliance

The final session of the State Alliance meeting involved discussion about future directions for states regarding HIT adoption. A very interesting topic brought up was the idea of disease surveillance and its rightful place in HIT and meaningful use. The idea is that by monitoring disease, communities will be able to exercise prevention by lowering the number of health cases and reducing medical costs. Discussion was also made regarding the lack of attention placed on public health departments and how they should be more engaged and articulated as part of HIT.

Farzad Mostashari, MD, MSc., the Deputy National Coordinator for Programs and Policy , talked about how "real time surveillance" could be used to monitor what diseases are becoming widespread and harming members within a certain community. He explained that it would also serve as a way to engage clinical partners, describing it as, "working smarter". Mostashari went on to mention that a major part of funding for these types of systems relies on evidence that it would truly work. For example, the Beacon Community Program , a grant program that targets communities that have already proven history of using HIT to boost measures such as cost efficiency, health care quality, or population health, is a method used to conjure up this evidence-based data health officials are looking for, since right now there is a lack of it.

Other future activities mentioned in the State Alliance meeting were the need to give states technical assistance through regulations and state consultations. Moreover, this would help states in implementing the grants states recently received from the Health Information Technology for Economic and Clinical Health Act (HITECH). Emphasis was placed on how important it is for state representatives and other stakeholders to bring up issues and provide recommendations to health officials in order to improve the quality and execution of HIT adoption. Furthermore, it was stressed for representatives from ONC and the Center for Medicaid Services (CMS) to trade solutions, as well.

The key factor that must be taken into consideration by stakeholders is the central motive for HIT; the concept of meaningful use. As a result, proving certain systems offer the most efficient, and cost-effective outcomes, is a major driving force for states, in winning funding to pursue HIT adoption. Vendors should pay extra attention to their solutions in ensuring that their systems capture certain data measurements so as to provide the evidence federal health officials are so adamantly seeking. Moreover, some concentration must also be placed on commonalities, and synchronizing systems to make interoperability in HIE possible. Lastly, privacy and security of these systems should also be incorporated in order to ensure meaningful use.