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FL behind in health IT, report says

By Carol Gentry
5/29/2009 © Health News Florida 

Eight states are leaders in developing a modern system of electronic medical records and are therefore in an ideal position to gain an early share of $17 billion in federal stimulus money, a Tampa-based consultant says. Florida is not among them. 

Laura Kolkman, president of Mosaica Partners, named the following eight states as leaders in adoption and use of health information technology: Arizona, Indiana, Kentucky, Massachusetts, Minnesota, New York, Ohio, and Virginia.

“They definitely are the leaders,” said Kolkman, chair of the information technology committee for the Health Information and Management Systems Society. Her report is entitled: "Leading Practices: Leveraging the Economic Stimulus Package for Health Information Exchange."

When Health News Florida sent the report to the Agency for Health Care Administration, which leads the project in Florida, the agency sent a prepared statement that implied disagreement with the report. "Florida is well positioned to leverage this funding to meet its ultimate goal of better health care for all Floridians by improving information access and coordination of care at the time of service," AHCA officials wrote. 

Kolkman presented her report at the society’s recent conference, which was abuzz in the wake of President Obama’s Feb. 17 signing of the American Reinvestment and Recovery Act. It contains $17 billion for states’ exchanges and $3 billion for national infrastructure.

In choosing the leaders, she said, she looked for programs that have a broad range of stakeholders, were “well-thought-out” and focused on specific outlines. She also looked for states that had offered financial support and strong leadership even before the federal government dangled the stimulus money as incentive.

“One thing they all have in common is a history of already preparing their state for improving the flow of health information, … supporting it from the governor’s level on down,” she said.

At the time Kolkman did the survey, March and early April, Florida officials “were just starting to put plans together," she said. "They’ve made some progress, but when I look at some of the other states…” She left the sentence unfinished.

Florida’s effort is in the hands of the Agency for Health Care Administration, with advice from the Health Information Exchange Coordinating Committee. To date, they have drafted a plan outline and accepted public comments through May 22. The first step in the plan, as outlined, is for AHCA to find a private-sector partner – “a not-for-profit organization, institution, or other eligible entity.”

By contrast, Kolkman said, Minnesota’s public-private collaborative was established in 2004 and had already developed a plan for adoption and use of electronic records before the stimulus act was written. In fact, it closely resembles the federal plan that emerged closely resembles it.

Last year the governor of Minnesota signed a law requiring all hospitals and health-care providers to have an interoperable electronic records system in place by Jan. 1, 2015.

In states that are leaders, Kolkman said, the process tends to be led by Departments of Health and universities;  they tend to place great emphasis on the involvement of patients and the impacts on public health.

Florida’s Department of Health gets only a brief mention in AHCA’s draft plan, toward the end, saying it will be a collaborator. DOH has one representative on the 16-member advisory committee, Dr. Robert Harmon, director of the Duval County Health Department. AHCA Secretary Holly Benson chairs the committee, according to its Web site.
Health News Florida sent Kolkman’s report to AHCA and asked for a response, which came in writing:

”We are very excited about the opportunities the economic stimulus funding offers all states to boost health information exchange efforts. Florida is well positioned to leverage this funding to meet its ultimate goal of better health care for all Floridians by improving information access and coordination of care at the time of service.

”The Health Information Exchange Coordinating Committee established under the State Consumer Health Information and Policy Advisory Committee in 2007, focuses on health information exchange issues and strategies for the state.

”Members of this committee include health care providers (including physicians, clinics and hospitals), health plans, information technology development organizations, the Florida Department of Health, universities, health care advocates and the Florida Office of Economic Recovery. The Committee has been designated by the Governor to advise the Agency and its stakeholders on these efforts.

”Florida’s Health Information Exchange Plan is posted for public comment at It includes an Action Plan for preparing a proposal to the Office of the National Coordinator for Health Information Technology for funding Florida’s health information exchange. Additional information on Florida’s health information network can be viewed at  We welcome input and comments to ensure that Florida is well positioned.”

--Carol Gentry can be reached at 727o-410-3266 or by e-mail.