Methods and Early Findings from an Evaluation of Health Information Exchange for Public Health in New York State

New York State is a pioneer in interoperable health information exchange through the Health Care Efficiency and Affordability Law for all New Yorkers (HEAL-NY). Through grants to Regional Health Information Organizations (RHIOs) and other groups, this multi-phase $200 million plus program promotes community-wide adoption of electronic health records and population health reporting. This study evaluates specific use cases of health information exchange for public health reporting (HIE for PH) being implemented by six (6) HEAL-NY Phase 5 grantees. It is conducted by the Health Information Technology Evaluation Collaborative (HITEC), an independent, third-party consortium of four NY State universities and experts in health IT. The design is a multi-level mixed methods comparative case study. The evaluation triangulates quantitative and qualitative data using an evaluation reference model developed to document public health use case implementation in relation to grantees' business culture, organizational environment, and vendor utilization across six grantees. The evaluation model documents how these elements influence progress of the grantees as they implement HIE for PH and allows identification of latent factors that may have an impact on individual success. Early findings suggest that a business sustainability model and internal organizational choices have a significant impact on the success and progress made by individual grantees. A need for communication across grantees and grantees' view of evaluation as a value statement for stakeholders have emerged as important factors. Our research establishes a unique evaluation framework for HIE for PH. Differences in funding, sustainability and growth identified in our comparative analysis results are linked to specific cultural and organizational differences among the RHIOs and capture the value added to each of the RHIO's stakeholders. These differences and components of success will inform policies regarding HIE for PH and the future growth of the statewide health information network envisioned by New York State.