California faces a wide range of healthcare-related issues which need to be addressed if the state is to avoid serious economic and social repercussions, and information technology (IT) may be a key element in addressing them.

"The lack of efficient healthcare coverage alone is a problem with huge economic implications," said CCST Council Member Stephen Ryan, President of the Doheny Eye Institute. "Many other issues are also pressing, including the health workforce shortage and disparities in care and outcomes. The use of IT based solutions is a viable route to explore and critical to meeting the present and especially the future healthcare needs of California."

Ryan is chair of a newly formed CCST healthcare committee, which has been formed to develop priorities for the state to address and to identify areas where CCST could effectively assist the state. In particular, the committee will focus on health information technology (HIT) and healthcare.

"California trails other states such as Delaware, Florida, and Wyoming which have already passed enabling legislation for the implementation of HIT statewide." Ryan told Council members at the February meeting. "There are significant costs involved, but overall, IT will ultimately reduce healthcare costs dramatically."

One such IT solution would be the creation of a statewide data exchange system and integration of the healthcare system. However, there are several barriers impeding implementation of such measures, including the lack of a trusted third party administrator for such a system and the lack of a viable business model. In addition, state legislation will almost certainly be needed to initiate and regulate such a system, and the value of such legislation would need to be demonstrated to the legislature. Moreover, challenges such as start-up costs, capital investments required, and patient confidentiality issues would need to be overcome.

"Medical informatics is advancing rapidly," said CCST Council Member Alfonso Cardenas, computer science professor at UCLA. "There is a need for major legislation or initiatives in the area of health information data exchange to improve healthcare quality, safety, and costs."

At the federal level, a National Health Information Infrastructure Initiative has been working since 2002 to develop a comprehensive knowledge-based network of interoperable systems of clinical, public health, and personal health information. The initiative, which is voluntary, is intended to improve decision-making by making health information available when and where it is needed.

"We look to the federal initiatives for leadership while developing an agenda and recommendations that are appropriate to our state and the many stakeholders, and especially to benefit the healthcare of all Californians," said Ryan.