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Report Details Failure of Conn. Health Information Exchange

By Jennifer Bresnick

An audit report and a former board member detail the demise of Connecticut’s state health information exchange.

If the past few years in health information exchange (HIE) history has taught the industry anything, it’s that not all organizations are destined for success.  In the case of Connecticut’s Health Information Technology Exchange (HITE-CT), which was shut down on July 1, 2014 by the state legislature, poor executive leadership and a lack of governance doomed the organization to failure.  A recent report from Connecticut’s Auditors of Public Accounts, coupled with a blog post authored by former board member Ellen Andrews on CT News Junkie,  detail the shortcomings of the HIE that led to its demise.

HITE-CT was established in 2010 as a quasi-public agency dedicated to supporting health information exchange and the adoption of health IT infrastructure throughout the state.  Its 20-member board of directors included the lieutenant governor and the commissioner of the Department of Public Health, among other stakeholders from governmental departments and others, including Ellen Andrews, PhD, Executive Director of the Connecticut Health Policy Project.

Despite its high-level leadership, however, the audit of the organization shows widespread disinterest from the board in fulfilling its obligations to attend important meetings.  Five board members attended less than half of the meetings held during a calendar year, while six missed three meetings in a row during that time.

“HITE-CT leadership blamed the changing market, a lack of legislative support, and changing requirements from the federal agency that oversees HIE, but the real problem was mismanagement,” agrees Andrews. “The board fell apart and attendance at the monthly meetings waned as major decisions were made in small committees between meetings, and just submitted to the board as a done deal. Most meetings included long executive sessions, held out of public view, to discuss the continuing legal, personnel, and management problems.”

Andrews also notes that the HIE ignored the prevailing public opinion on patient privacy, which would have produced an opt-in structure to participation.  “HITE-CT Board leaders even testified against a bill to let people decide how their information is used,” Andrews says. “Bad privacy policy undermines public trust and that lack of trust contributed to HITE-CT’s failure.”

Financial problems also plagued the organization, the audit report found.  According to HITE-CT’s financial statements for the years of 2012, 2013, and 2014, the HIE’s net investment of capital assets amounted to no more than a few thousand dollars: the book value of its computer equipment.  The HIE was never able to generate any income because it never succeeded in beginning operations, the report adds.  No HIE services were performed through HITE-CT before it was dissolved, and the organization could not meet federal grant matching requirements due to a lack of generated income.

While the Connecticut State Innovation Model (SIM) was among the programs recently awarded federal funding to pursue tests of its proposed health IT and care quality reforms, Andrews notes that many of the board members from HITE-CT are also involved in the SIM effort.  “Hopefully, they’ve learned from their failure and won’t repeat the same mistakes this time,” she concludes, noting that the SIM plan includes several promising strategies to foster patient engagement and meet the needs of the population. “Connecticut deserves better.”

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