Picture Positive For State Health Care IT Despite Budget Squeeze

State governments are finally getting up to speed when it comes to taking a good look at health-care information technology and how to leverage its benefits concurrent with federal initiatives.

That's the word from a new report this week from the National Conference of State Legislatures (NCSL) that said lawmakers around the country introduced more than 370 bills related to health-care IT in an 18-month period from 2007 to 2008.

The NCSL said during that period 132 bills containing health information technology provisions were enacted in 44 states and the District of Columbia -- three times the number of health-care IT bills enacted during the same period from 2005 to 2006. The topics of e-prescribing, electronic health records, financing and planning/study commissions figured most in laws passed.

"Collectively, we're encouraging our members and legislatures and governors to look at health IT as a way to contain the rising costs of health care," said Massachusetts state Sen. Richard Moore, vice president of the NCSL, in an interview with ChannelWeb. "They've got to get health costs under control, and not only is health IT been demonstrating itself as a way to control those costs, but also a way to get better understanding of what kind of trends exist."

When it comes to IT's role in shaping different economic sectors, the health-care sector, as a whole, has been late to the party, Moore agreed. With President-elect Obama and incoming Department of Health & Human Services Secretary Tom Daschle making health-care IT a priority for the administration, Moore said the NCSL's year-and-a-half old Health Information Technology Champions (HITCh) program -- along with other public-sector entities -- will work to keep the momentum going in 2009.

"The revolution has happened," Moore said. "Now it's a matter of taking advantage of that and expanding care to larger parts of the population The concerns we're hearing from [state CIOs and others] include the issue of having software that's interoperable. We're working with a range of task forces and experts in the field to make sure there's some national standards the vendors, in particular, can follow -- standards we can write into most of the bills."

"The other area is security," he added. "There is concern among legislators and others who see things in the private sector like TJX's data being compromised, and they want to make sure health providers are responsible."

Health-care IT security standards are a perennial hot topic -- the year-old Health Information Trust Alliance LLC (HITRUST) is the latest entity attempting to recommend a single set of security standards for health-care IT to lawmakers and vendors alike. Is the adoption of a security standard something that's realistic in the next few years?

"I think it's very realistic," Moore said. "There's a lot of effort going on to develop that standard. The people who are handling that information have to be trained, encouraged and incentivized -- or rather, deincentivized -- to not let that out of their hands. States will be looking at what constitutes misuse of information and staying up to date with what the penalties ought to be."

Health-care efficiency and other cost-management maneuvers are on the minds of all state lawmakers as they prepare to open the 2009 legislative session with the news that at least 15 states are already forecasting double-digit budget gaps in FY2010.

Another report released by the NCSL earlier this month suggested that while states have already closed $40 billion in fiscal year 2009 budget gaps, they will contend with having to close an additional $97 billion over the next 18 to 24 months. The largest of the 15 states slated for double-digit gaps include Arizona (24 percent), New York (20 percent), California (18 percent), Wisconsin (17 percent), Minnesota (14 percent) and Kansas (14 percent).

"These budget gaps are approaching those seen in the last recession, which were the worst since World War II, and show every sign of growing larger," said NCSL Executive Director William T. Pound in a statement.

Rising costs for health care, including Medicaid and other social services programs, are weighing down state budgets left and right, and deteriorating revenues are hardly helping the problem.

According to the NCSL, at least 10 states have imposed and another 10 states are considering across-the-board budget cuts; 19 states have implemented hiring freezes; 14 states have banned travel; 4 states have frozen salaries; and 5 states have tapped their rainy day funds with as many as six more looking to do so. The NCSL expects more than $3.7 billion in rainy day funds to be tapped in fiscal year 2009.

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