Thinking nationally, starting locally

California: The California HealthCare Foundation, a philanthropy organization focusing on improving how health care is delivered and financed in the Golden State, earlier this year started encouraging medical centers to use electronic health records and facilitate electronic delivery of laboratory results to clinicians' offices. The organization provided $10 million to the Santa Barbara County Care Data Exchange, which lets patient-specific clinical information to be securely and readily accessible to any authorized person, including the patient. It serves Santa Barbara County as a peer-to-peer information exchange.

Colorado: Aiming to create a local health information infrastructure that can be integrated into a national clearinghouse, a consortium of hospitals and health maintenance organizations created the Colorado Health Information Exchange in 2004. By late 2009, officials hope to expand COHIE into the Colorado Regional Health Information Organization'a data-sharing, self-sustaining nonprofit organization that would maintain a robust technical environment and support national standards and public health interfaces.

Massachusetts: Since its 2003 inception, the Massachusetts SHARE program, a regional collaborative effort aimed at promoting the sharing of health care data between organizations, has raised $1.1 million for its projects. Over time, the group envisions designing systems to assemble, organize and distribute real-time medical information.
Indiana: If anyone in the Hoosier State comes down with basketball fever, the Indiana Health Information Exchange will get those patients the help they need with the click of a mouse. The first phase of the IHIE project started in August 2004, and by the end of this year every health care provider in central Indiana will have an electronic database.

Florida: Still in development, Florida's nascent Health Information Network (FHIN) is an attempt to connect the state's health care interests. State lawmakers in May appropriated $1.5 million for the program.

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