Healthcare Information Technology Moves Forward in Administration, Legislature

The state is continuing its focus on healthcare information technology (HIT), with new action by both the Legislature and the Governor’s office to enable the creation and management of an effective HIT system in California.

In March, the Governor issued Executive Order S-06-07 aimed at advancing California’s efforts to adopt health information technology (HIT), increase transparency of quality and pricing information, and increase accountability in public and private health care delivery systems. The executive order identified key actions for the state to pursue, including providing state leadership for 100 percent electronic health data exchange, leveraging state purchasing power, developing a quality reporting mechanism through the Office of the Patient Advocate, and strengthening the ability of the Office of Statewide Health Planning and Development to collect, integrate and distribute data.

Executive Order S-06-07 follows on a number of initiatives related to HIT which the governor announced in January, including the establishment of a Deputy Secretary of HIT and a State HIT Financing Advisory Committee to coordinate the state’s HIT efforts and develop financing mechanisms; implementing universal e-prescribing by 2010; developing standardized personal health records (PHR) within the public and private sectors; and implementing a county-level pilot electronic medical record system for mental health patients within the requirements of Proposition 63, the Mental Health Services Act. It also follows on Executive Order S-12-06, issued last year, which directed the secretaries of Health and Human Services and Business, Transportation and Housing and the director of the Department of Managed Health Care to devise strategies to expand the use of HIT.

On the legislative side, SB 320 (Alquist), introduced in March 2007, requires the state office that oversees the implementation of the federal Health Insurance Portability and Accountability Act to establish and operate the California Health Care Information Infrastructure Program to provide all Californians with a personal health record, improve the quality of health care in California, and reduce the cost of health care through the advancement of information technology. Alquist introduced HIT legislation last year as well (SB 1338), which was superseded by EO S-12-06.

CCST has been focusing on the potential benefits of HIT to California since 2005, when it featured HIT as the principal theme of its October Council meeting (held jointly with the Institute of Medicine). A study by the RAND Institute has suggested that the state could save as much as $8 billion annually from greater efficiency, reduced medical errors, and improved quality of care. CalRHIO, in a separate analysis, found that without sharing patient records electronically, physicians could not find information previously recorded in a paper chart 30% of the time, and were not aware of 25% of patient prescriptions. A more comprehensive analysis of potential HIT benefits and challenges for California was released by the Legislative Analyst’s Office in March 2007, A State Policy Approach: Promoting Healthcare Information Technology in California, which served as background material for SB 320.