A Health IT Policy Committee workgroup will focus its attention on state-level health information exchange issues, after identifying those that need policy solutions.

Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, told the federal Health IT Policy Committee Wednesday that the information exchange workgroup, which he co-chairs, will narrow its focus on state HIEs as early adopters begin to set them up.

In a brief report to the Policy Committee, Tripathi said many HIE issues may arise at the state level and at the intersections of state and federal HIT implementations.

The workgroup will create an advisory panel of state-level HIT coordinators to facilitate communication with federal HIT policy organizations, he said.

Tripathi also said the workgroup, which Deven McGraw of the Center for Democracy and Technology co-chairs, will modify its membership to reflect the new focus.

Dr. David Blumenthal, the national HIT coordinator, agreed at the meeting that state-level issues warrant attention. Other Health IT Policy Committee members also applauded the plan.

Judith Faulkner of Epic Systems Corp. said she had begun to be concerned that states would adopt health IT rules that might conflict with one another. That could make it difficult for systems vendors like her company to conform with all of them.

Tripathi said the workgroup also will concentrate on information exchange transactions that are necessary for healthcare providers to achieve meaningful use and garner federal subsidies for employing health IT.

If affordable products to support all of the transactions are not universally available, he said, the workgroup will consider how the gaps can be remedied.

Those fixes might include state and federal policy initiatives or other "market correcting or reinforcing actions," he added.

As one example of an issue the workgroup may tackle, Tripathi said, where does the Nationwide Health Information Network end and state-level health information exchange begin?

The workgroup's original charter called for it to make recommendations on "policies, guidance governance, sustainability, architectural, and implementation approaches to enable the exchange of health information and increase capacity for health information exchange over time."

This not only was too broad, Tripathi said, but it also conflicted with the assignments of other official workgroups.