State e-health collaboratives across the country are gearing to submit their operational plans for the health information exchange (HIE) portion of the federal stimulus funds under the HITECH Act. New York eHealth collaborative is no exception, but it finds itself at a critical juncture.

With a new executive director leading the not-for-profit corporation, NYeC is at an "important crossroads" for what its next steps will be, according to Carol Raphael, its board chairwoman.

NYeC has an infrastructure enviable for its maturity, private/public collaboration and sizable investment. Eighteen individuals sit on the board, representing policymakers, provider organizations, physicians, employers, consumers and leaders in health IT.

"It's an unusual, genuine private/public partnership," Raphael said.

The organization has been able to reach consensus on privacy and security policy and governance, and has begun technology requirements for the statewide HIE.

New York State invested $250 million into the collaborative and the private sector provided $200 million. With that much money on the table, NYeC wants to ensure that the state's investment in health IT produces a substantial return on investment, Raphael said.

"In light of the economic environment, the state had the foresight and the commitment to health IT not to cut the budget," Raphael pointed out.

Physicians top priority

"There's a lot to build upon here," said NYeC executive director David Whitlinger. NYeC has been appointed by Gov. David Paterson to be the state-designated entity for the HIE federal funds and has also submitted a request to be one of the Health IT Regional Extension Centers - a "top priority" to help physicians roll out electronic health record systems, Whitlinger said. "A health information exchange network isn't useful if the physicians don't have basic EHR systems."

Fifty percent of physicians in the state are in 1-2 physician offices, Raphael said. While integration will be a challenge, Whitlinger noted the "enormous" amount of work that has already been done to provide coverage and services beyond the pilot level. NYeC is hoping to get between 6,000 to 10,000 physicians rolled out with EHRs in 2010 and having them achieve meaningful use in 2011, Raphael said.

NYeC is using the Health Care Efficiency and Affordability Law of New York State (HEAL NY) funding it received already to start work on the Statewide Health Information Network for New York (SHIN-NY) by connecting regional health information organizations and health information exchanges. Whitlinger said. One of the 2010 goals is to help RHIOs and HIEs reach sustainability and replicate the business case to other RHIOs in the state. "This is key to our agenda and long-term view," he said.

Along with statewide connectivity and physician adoption of health IT, NYeC is also focusing the first part of 2010 on aligning its connectivity strategy with the national program, the Nationwide Health Information Network and the work being done by the Health Information Technology Standards Panel (HITSP).

"We have a vision toward the future of interoperability and shared data," Whitlinger said. "IT is a tool. The destination is to make the healthcare system more efficient, responsive and integrated and higher quality." The bottom line, says Whitlinger: "We have to have a connected healthcare system."