Health Information Exchanges and Megachange

In this paper, Darrell West and Allan Friedman study how state-level health information exchanges (HIEs) are implemented, where there are opportunities for action and who drives policy change. This paper looks at the current climate for organizational change and study the challenges faced by HIEs and how new technology is moving forward to overcome them; the scholars argue that for these megachange efforts to be effective, policymakers must present a clear vision, achieve consensus on key objectives, overcome organizational and market fragmentation, and work effectively with a range of different constituencies. In particular, this paper addresses the effectiveness and viability of HIE’s in Indiana, Massachusetts, New York, Tennessee, and California and explores why Massachusetts and Indiana are most successful across a number of metrics. CTI also hosted a forum on HIEs to discuss the paper...