Integrated State Health Information Systems
Summary of a Workshop for State and Local Health Policymakers
This workshop offered State and local policymakers different models of integrated health
information systems to help them understand how these systems can support program management
and public policy development. It was held in San Diego, California, July 9-11, 1997.
About the Workshop Sponsor.
Overview
Many of the public and private organizations that comprise the health care marketplace collect
health information. As the health information needs of these organizations have grown, health data
sets have proliferated.
While different organizations may have a variety of purposes in collecting
and using health information, their information needs frequently overlap. Often, failure to recognize
similar information needs and the propensity of States to distribute the effort of collecting and
maintaining a growing body of information among different agencies have produced both public and
private efforts that are inconsistent, incomplete, or redundant.
Spurred by a growing recognition of
these problems together with recent and ongoing advances in technological capacity to manage
information, some States have begun to build integrated health information systems—that is,
systems that compile health information in a standardized manner and allow electronic access by
multiple users for multiple purposes.
Rapid and ongoing changes in the health care system also have caused the States to rethink their
goals and systems for collecting and using health information efficiently. A growing number of
States are attempting to coordinate existing data streams, making available data consistent and
accessible for multiple purposes. These purposes include the oversight and management of public
health, monitoring health care outcomes and quality, managing State Medicaid programs, and
promoting competition to control health care costs.
The prospect of developing and maintaining integrated health information systems challenges the
traditional roles and relationships among State agencies—including State public health agencies,
various State health regulatory and licensure agencies, and State Medicaid programs. Moreover,
addressing public policy concerns about health care quality, access, and cost effectively may entail
forging information-sharing partnerships with private-sector organizations, including large purchaser
organizations, community health information networks (CHINs), or community health information
management systems (CHIMSs). Sharing information among public agencies and across private-public boundaries raises important real and perceived problems of confidentiality that are not easy to
address.
Objectives
This workshop provided a framework for understanding the scope of State health information needs
and the possibilities for building a health information infrastructure that could be shared among State
and local agencies and, potentially, also among private organizations.
A special feature of the
workshop was a full afternoon session in which participants in small groups had the opportunity to
explore three different State integrated information systems in on-site demonstrations and to ask
questions about the structure and use of these systems.
Other sessions focused on how integrated
health information systems could be built and used to address broad State policy needs, specifically:
public health oversight, quality assurance, Medicaid management, promoting competition, and
ensuring confidentiality.
The specific objectives of the workshop were to:
- Introduce the concept of integrated information systems and explore the reasons why State
health policymakers are supporting their development.
- Provide examples of operational integrated State health information systems, demonstrate how
they work, and discuss their goals, advantages, and limitations.
- Discuss alternative strategies that States can use to develop and maintain integrated information
systems.
- Discuss State information needs related to the States' oversight and management of public
health.
- Discuss State information needs related to monitoring and regulating the quality of health
services.
- Discuss how the integration of existing information systems can address the States' growing data
needs for Medicaid program management.
- Explore State information needs to promote effective competition in a market-driven health care
system and the information-sharing arrangements which might help States to address those
needs.
- Explore the issue of confidentiality in developing and managing integrated information systems,
focusing on the requirements of Federal law, legal and administrative problems, and the
technical issues involved in preserving confidentiality.
- Explain technical strategies and technologies of information system management and
confidentiality.
Participants
The participants for this workshop included State and local policymakers in the legislative and
executive branches of government who are interested in building State capacity to develop and
manage integrated health information systems. Among them were State health insurance specialists,
information systems managers, directors of planning and policy commissions, officials from State
Medicaid agencies, State and local health departments, as well as representatives of Federal agencies
and national associations.
Workshop Sessions
The User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.
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