IHIN Governance Watch

12/5 IHIN Government Relations/Legislative Watch

Iowa Health Information Network governance change proposed:  The Iowa Health Information Network (IHIN) currently functions under a state government-led governance structure with a heavily involved public and private advisory council named Iowa e-Health.  The current structure is no longer considered as suitable for the long-term sustainability of the IHIN as others that exist and have recently been examined. The Iowa Department of Public Health (IDPH) is working with the Iowa e-Health Business and Financial Sustainability Workgroup - a subgroup of the Iowa e-Health Advisory Council - to recommend an alternative form of governance.  This recommendation will be made to the State Board of Health and requires changes to Iowa Code 135.154 to 135.156 in order to begin this effort.


There are a number of reasons for this recommended governance change. Government requirements for procurement, contract execution, hiring, and travel processes can be cumbersome, time consuming, and without needed flexibility.  All make it difficult to react quickly to technology innovations in the rapidly changing and evolving space of health information technology and Health Information Exchange (HIE). In short, the IHIN is at the mercy of highly measured and very deliberate government processes. The vulnerabilities this environment creates increases the financial risk to the millions of dollars that have been invested in the IHIN thus far by state and federal government and currently participating health care organizations. Iowa Code Section 135.156A requires the IHIN to be self-sustaining therefore the IHIN must charge reasonable fees to enough participants to generate a sufficient revenue stream to cover its operating costs. Lengthy timeframes are burdensome to any business and especially one in the health information technology (health IT) marketplace. Timely reaction to customer needs is extremely challenging under the current state-government led governance structure. The IHIN must be in the position to respond to changing customer needs in the marketplace with more urgency than the current state government-led model can provide.


Recommendation Under Review: The IHIN governance and operations should transition from a state government-led model to a private not-for-profit model to ensure its long-term business and financial sustainability. This model fits Iowa’s collaborative health care environment well as evidenced by the success of the current Iowa e-Health Collaborative. The Iowa e-Health Collaborative is a public and private collaboration that works to improve health care quality, safety, and efficiency through appropriate implementation and use of health IT. Competing healthcare organizations work together on a public good which enables the exchange of health information maintained in each of their systems.  Health IT can bring quality improvements as well as operational cost efficiencies to organizations and HIE further expands those benefits. The success of the Iowa Health Information Network is directly attributable to the efforts of the Iowa e-Health Collaborative.


The next meeting of the Iowa e-Health Advisory Council Meeting is December 5, 2014 10:00AM - 2:00PM at Mercy Medical Center - East Auditorium  on 1111 6th Avenue, Des Moines and is open to the public. The IHIN Governance Transition 2015 Legislation is on the agenda.