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State governments are leading the way to promote adoption of interoperable health care information technology systems, says Lori Evans, deputy director of the New York Department of Health. In part, the states are stepping up to fill a leadership vacuum in the federal government, she contended.

Evans, who leads the department’s Office of Health Information Technology Transformation, spoke at the American Health Information Management Association Annual Conference in Seattle. She told attendees that at least 35 states have initiatives in various stages of maturity.

New York, for example, is funding up to $200 million to help providers adopt I.T.  and build health information exchanges. In November, the state will publish policies covering a variety of issues that are required to advance interoperable HIEs across New York. The state health department  is building its own infrastructure to communicate with HIEs, the Centers for Disease Control and Prevention, and other stakeholders.

A variety of other state measures are in progress across the nation. Minnesota has mandated interoperable electronic health records by 2015. A California executive order requires e-prescribing by 2010. Rhode Island recently enacted a law to establish and fund a statewide HIE. Still, there remain thousands of silos of health information across the nation and no consensus on how to communicate among them, Evans said. And that’s got to change, she added. “Health information is a public good, it is not a private access.”

States can go a long way toward fostering consensus by agreeing on governance issues and setting policies on consumer protections, interoperability, access rights, responses to breaches, and audits, Evans said.

To a small degree, that’s already happening in New York, she noted. In two regions of the state, two governing entities in each region are sharing the same HIE.