When the Illinois General Assembly appropriated $3 million for statewide HIE planning, the Illinois Department of Healthcare and Family Services (HFS) Office of Planning staff devised a process whereby the state would be divided into 16 Medical Trading Areas (MTAs) that reflected a patient-centric model of medical care transactions and referrals within a geographic region. An Illinois Medical Training Area refers to a geographic subdivision of the State based on locations where a majority of people who live in a particular area receive their health care. MTA designations ensure that state planning efforts for HIE are based on the true needs of patients and the healthcare providers they go to for services.
In 2009 HFS designed a one-year Health Information Exchange (HIE) planning process that culminated with the development of one- and three-year plans along six domains for health information exchange. The MTA HIE planning process was initiated with an emphasis on both governance and local stakeholder engagement.
IPHI supported stakeholder engagement and monitoring for the grants reporting process of the MTA HIE planning process. IPHI implemented broad stakeholder engagement by holding regular “Executive Council” meetings and routine “Regional Advisory Council” or smaller Work Group meetings to keep members informed and motivated. Among the common elements of successful engagement were one-on-one meetings to engage key decision makers (hospital executives, physician leaders and practice managers) and identifying HIE “champions” among a group of clinicians who had adopted EHR to “spread the word” among their peers.
The year-long MTA HIE planning process was designed to accelerate interest and acceptance of HIE in Illinois. As a result of the process, multiple multi-county initiatives emerged that ultimately led to the creation of regional exchanges. The Illinois Health Information Exchange worked closely with each of these regional HIEs, with the goal of maximizing flexibility, efficiency and statewide participation. This provided a pathway for every provider in the state to participate in HIE.
On June 30, 2010, the MTA planning process effectively concluded with the submission of extensive one- and three-year plans from fourteen of the sixteen MTAs. These plans were compared, collated and combined to enrich and support the efforts of the Office of Health Information Technology and the Illinois Health Information Authority to establish comprehensive health information exchange in Illinois.
As a result of this work, effective stakeholder engagement and similar efforts, Illinois now has six regional HIEs:
- Central Illinois Health Information Exchange (CIHIE)
- Illinois Health Exchange Partners (ILHEP)
- Lincoln Land HIE
- MetroChicago HIE
- Northern Illinois HIE
- Southern Illinois HIE
The planning and stakeholder engagement involved in developing these HIEs has helped establish governance structures, increased provider collaborations, create an operational framework as well the social capital necessary to sustain HIEs and promote state-level interoperability.