State-level data governance efforts 'shaky at best'

State level governance efforts for storing and exchanging citizen data--including health information--are "shaky at best," according to Chad Grant, a senior policy analyst with the National Association of State Chief Information Officers.

Grant (pictured), who spoke at the Government Health IT Conference & Exhibition in Washington, D.C., on Wednesday, was touting the results of a collaborative study published this week by NASCIO and HIMSS on the health IT landscape in the states. Overall, 80 percent of responding state CIOs said they had no data governance structure in place at all.

"There are effective point solutions within specific agencies, but managing information as an enterprise asset will require effective data governance," the report's authors wrote. "Numerous states shared that they are still in the development phase and that they are looking into a statewide longitudinal data system."

The study also examined the status of Medicaid eligibility systems and Medicaid Management Information Systems, as well as the role of state CIOs in state level health information exchange (SLHIE) efforts. Overall, 78 percent of responding state CIOs reported that their MMIS efforts would be completed by 2014, while 72 percent of respondents said that their state will be implementing an eligibility system before 2014.

Seventy-two percent of responding state CIOs said they played a "specific role" in SLHIEs, that included:

  • Administration of state HIE grants
  • Oversight, as directed by state statuses
  • Participation on the SLHIE's Board of Directors as an ex-officio, non-voting or co-chair
  • Provision of guidance or management with the state's technology strategy, software applications, technical infrastructure and/or services.

According to the study, 80 percent of SLHIEs indicated that in-kind resources were a key funding source, while 48 percent said the same about grants. Many also said that they using some type of fees to drive revenue.

"The states are really looking at the future in terms of long-term sustainability," Grant said.

A survey published in March by the National eHealth Collaborative found that a majority of HIE stakeholders were worried about the financial sustainability of HIEs. Last month, the Office of the National Coordinator for Health IT unveiled a framework for HIE governance it said would provide a "common foundation" for all types of HIE governance models.

To learn more:
- here's the study (.pdf)