On July 6, 2010 the The Office of the National Coordinator for Health Information Technology (ONC) sent written guidance to states and state designated entities regarding HIEs:
Executing Strategy for Supporting Meaningful Use
Operational plans shall describe how the state will execute the state’s overall strategy for supporting Stage 1 meaningful use including how to fill gaps identified in the environmental scan. Specifically, states and SDEs shall describe how they will invest federal dollars and associated matching funds to enable eligible providers to have at least one option for each of these Stage 1 meaningful use requirements in 2011:
- E-prescribing
- Receipt of structured lab results
- Sharing patient care summaries across unaffiliated organizations
I first heard about this guidance to the states about a month ago. At the time I was puzzled how ONC thought state HIEs would ever be involved in ePrescribing. Providers do not need assistance from the HIEs to implement ePrescribing. This is solely the domain of the provider EHR and the existing Pharmacy exchange managed by SureScripts. I thought that they would realize this and back away, but surprisingly it made it to writing.
So, what does ONC expect the state-designated HIE to do regarding ePrescribing? If you read the entire Program Information Note there isn’t any sort of clue. Does anyone have any insight regarding this?
Candid CIO 
My insight is the lack of medical knowledge used to prepare this state-designated HIE. If you want these programs to really work, they need to be designed by medical people. Too much non medical input in a completely medical field!
There’s a fundamental problem with “central planning”. It assumes that some nameless, faceless, disinterested party can make decisions better than those who have a direct relationship to the patient and the problem.
We will continue to see this kind of nonsense come out of Washington because this kind of nonsense has always come out of Washington. It’s baked into the structure of “central planning” so we’d just better get used to it. (Me? I prefer to return to our roots where the patient/doctor relationship was sacrosanct, but that doesn’t seem to be in our national psyche at the moment.