Connecticut's health information exchange, known as Health IT Exchange (HITE-CT), has failed, in large part due to internal mismanagement and bad privacy policies that undermined the public trust, according to Ellen Andrews, executive director of the Connecticut Health Policy Project.
In a December blog post, Andrews said that the HIE wasted $4.3 million in federal grants and accomplished nothing in its four years. She noted that many decisions were made in small committees behind closed doors and presented to the board as done deals. The HIE also refused to adopt a consumer opt-in policy, as used in neighboring states, which would have provided more privacy and security of patient health records.
Connecticut's General Assembly recently repealed the laws establishing the HIE and transferred some of its responsibilities to the Department of Social Services (DSS).
A recent auditor report of HITE-CT found deficiencies in internal controls, noncompliance with laws, and inadequate management practices and procedures. The HIE has had no chief executive office since August 2012. It also never provided services and never developed a self-sustaining revenue stream.
DSS, which administers the Medicaid Meaningful Use program, is now starting over, beginning with town hall meetings about a new HIE.
"Hopefully, they've learned from their failure and won't repeat the same mistakes this time," Andrews wrote. "Connecticut deserves better."
HIEs are intended to serve as a solution for the exchange of patient data among providers using different electronic health systems. However, there is no one recommended governance structure or business model; AHRQ has tried to fill the gap by issuing an HIE evaluation guide.
A recent RAND study noted that HIEs are still experiments, and it was not yet known whether they are delivering as promised. Some exchanges around the U.S. have been running into legal and other troubles.