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Progress and promise: The original HIEs

With the other HIE, health insurance exchanges, now taking the market by storm, it is easy to forget the exchange that first caught our attention and dominated our coverage for so long: health information exchanges (HIEs). Indeed, even a cursory glance back at the written analysis of our health care and social services team makes evident the importance of these exchanges. With a nod to our historical work on HIEs, a look at the current procurement landscape, and an examination of a current statewide HIE request for proposals (RFP), one will get a sense of both progress and potential through this latest analysis.
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Our first mention of health information exchanges came back in 2007 as part of a discussion about the cost of health information technology (HIT). At the time, we found that a lack of public policy and opposition from individual physicians was stalling adoption of HIT initiatives like HIEs. In two short years, the country experienced a change of leadership and a great recession, and the public policy will to adopt HIT came to fruition.
In early 2009, we saw the future of health care reform through stimulus funding for electronic health records and HIEs. The American Recovery and Reinvestment Act (ARRA) of 2009 provided approximately $150 billion in health care spending, including $564 million under the Health Information Technology for Economic and Clinical Health Act (HITECH). States were granted one award, ranging from $4 million to $40 million per state. The State HIE Cooperative Agreement Program funded states' efforts to rapidly build capacity for exchanging health information across the health care system.

And rapidly build they did. In 2010, just one year later, we saw 27 states release an RFP or award a contract for their HIE. As of today, that number has risen to 46 states, with only four states still working on an RFP. A quick glance at today’s map might leave some with the impression that, given the prevalence of red, there is no more work to be done in this space; however,that is the wrong conclusion to draw...
The remainder of this analysis is subscriber only content. Subscribers have access to expanded analysis on opportunities, and detailed date, here 

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