CIOs who are keeping a close watch on the Health Information Exchange (HIE) and Regional Extension Center (REC) efforts in their states are worried the country might be building a Tower of Babel, as Catherine M. Szenczy, senior vice president and CIO of MedStar Health in Columbia, Md., put it.

Szenczy was in the audience Thursday at a session on state coordination and collaboration at the CHIME10 Fall CIO Forum in Phoenix. The talk from a panel of four was more about fragmentation and chaos than coordination.
Neal Ganguly, CIO at Centra State Health System in Freehold, N.J. one of four panel members, described the dealings in his own state with 12 HIEs – four of which have been sanctioned by the state.

"It speaks to the lack of coordination at the state level," he said. "We are at the point of wasting a lot of resources. The HIE coordinator in the state really has no hands-on experience. The timing is not working out right."
In Kentucky, there are two RECs – government-designated and funded entities charged with helping small physician practices and critical access hospitals adopt electronic health records.

One is headed by a 23-year-old recent graduate, Randy McCleese, vice president and CIO of St. Clair Regional Medical Center in Morehead, Ky., told the audience. "Some green folks are trying to do these things we've been trying to do for years. They're green. They don't understand the complexities of what they're doing."

State coordinators and and CIOs need to reach out, McCleese urged the audience. "Make sure they get the benefit of your experience."

Reaching out is what CHIME has in mind through its StateNet program, a 50-state network of CIOs created to facilitate the sharing of best practices and strategies to assist information exchange development and state-level cooperation.

CHIME is offering to help the 62 Regional Extension Centers across the country by providing CIO expertise in all 50 states as the RECs assist small physician practices and critical care hospitals adopt and use electronic health records.

CHIME has already written a letter that will go to all Regional Extension Center directors. First, it has to be reviewed and approved by Health and Human Services Secretary Kathleen Sebelius.
 
"Together, hospitals and primary care providers are challenged to be meaningful users of technology," said the letter, signed by CHIME President and CEO Richard Correll and David Blumenthal, MD, national coordinator for health information technology. "Our mutual success depends on strengthening partnerships and building collaborative relationships."
Building collaborative relationships is happening in Texas, said Ed Marx, senior vice president and CIO for  Texas Health Resources. He chairs the board of the Texas Health Services Authority (THSA), which recently completed HIE strategic and operational plans.

"Our state government has been on top of this," he said, "but it hasn't been just a hospital-driven thing." Many stakeholders are at the HIE table, he said, including payers and patients. "We're all on the same sheet of music."