For a short month February sure packed in a lot of activity, especially for the health care market. Reports from last month continued to make headlines that health care spending reached $2.5 trillion in 2009 and is projected to be $4.7 trillion in 2019. The recession gets the blame for this largest one-year increase on health care spending in 50 years. Since there is much money being spent on healthcare it is no wonder it is front and center as an industry for opportunities to drive vendors' revenue. February found Maximus adding DeltaWares' electronic health record (EHR) technology to its repertoire. EHRs have likewise spurred a partnership between NextGen and Ingram Micro. Microsoft and Eclipsys announced they will combine certain Eclipsys health care IT applications with Microsoft's Amalga Unified Intelligence System. In addition, IBM is expanding its analytics business by acquiring Initiate Systems and ACS now has its new position in the marketplace branded as "ACS, A Xerox Company". Expect to see more activity in months to come.

A whole lot of spending money
Forty states agencies and State Designated Entities received awards in the first round of health information exchange (HIE) grant funding which totaled $386 million. Plenty of participants are happy to receive the HIE funds but they are still trying to figure out their strategies. Providing matching investments will be no small matter for most states and some are still looking for information on how the HIE will work and exactly what it will provide. There are concerns that there may not be enough done to ensure that the money isn't being wasted. Some states are finding it difficult to become invested when they don't ultimately understand the HIEs and how they will be self-sufficient once the money is gone. Despite some concerns, states are detailing their statewide planning approaches to determine where they are, what is needed and ways to get there. This will help states determine how they will need to utilize vendors. Here's a sample of state activities:

Pennsylvania wants to piggyback on the Delaware Health Information Network's existing contract because they feel it is a proven platform based on interoperable standard, is scalable to meet their needs and would satisfy the Office of the National Coordinator's request for states to look into multi-state collaboration to make the best use of federal incentive funds. INPUT is tracking the opportunity under INPUT ID # 57863.

Missouri plans on releasing a Request for Information (RFI) to help gather more information on the technical approach and financing assumptions of their HIE. Missouri has their eye on submitting their plans to the Office of the National Coordinator for Health IT (ONC) by May 31st. INPUT is tracking the opportunity under INPUT ID # 60207.

Illinois intends to release a solicitation soon for HIE technical planning services. They will be looking for project management and planning assistance, including the development of strategic and operational plans as well as the state HIE roadmap to help determine next steps for the procurement process of the HIE system. INPUT is tracking the opportunity under ID # 59517.

Massachusetts released a draft Health IT plan in January. They are looking at a statewide HIE with collaborative governance and sustainable funding model. Their strategy is to leverage existing electronic health record and HIE efforts. INPUT is tracking the opportunity under ID # 59998.

Also in February, the Health and Human Services announced $100 million in grant funds from the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) to 10 states to improve health care quality and delivery systems for children enrolled in Medicaid and CHIP. These states will use the grants to utilize health IT for quality improvement initiatives.

On a path towards interoperable health information exchange
During February's State Alliance for e-Health meeting, presentations focused on ways to improve the adoption of health IT and operations states should take in order to jumpstart the process. Representatives from various departments and states facilitated conversation pertaining to HIE deployment, sustainability and future activities for the State Alliance. Farzad Mostashari, MD, MSc., the deputy national coordinator for Programs and Policy from ONC explained how states need to focus on incremental changes for the HIEs, by first working on simple exchanges and focusing on factors such as authentication and validity. For further insight into the meeting check out INPUT's Analyst Recap report.

Google's plans to tackle broadband
A notable first this month is Google's plan to experiment with providing super high-speed Internet service. One of their visions is to "allow rural health clinics to send 3D medical images over the Internet". This could be a big step if any medical communities actually get involved in the experiment, potentially stimulating their digital records efforts.

INPUT's Take
I think last month's hodgepodge of activity is a good indicator of what is to come this year as states flesh out their strategies for operations and sustainability of statewide HIEs. They will be looking to leverage existing capabilities and lessons learned from already developed HIEs. Vendors should understand that states are at all different levels of maturity and even if a state had previously developed a Health IT roadmap, they will likely have to revisit plans to ensure they align with national requirements. Consultants should look to those HIE planning initiatives for opportunities as states are setting aside funds for environmental scans, cost benefit analyses, project management, advanced planning documents and so forth. Those that have already made investments will begin to develop plans on how to connect pilot projects and regional efforts. Broadband offers great promise in the medical area and Google's innovations offer a glimpse at the future as we wait to hear more about the federal government's national plans for broadband networks in the next couple of weeks.