An annual survey of the progress of health information exchanges across the nation has found 234 active HIEs in 2010, compared with 193 in 2009.

The 234 active HIEs include 56 state-designated HIEs that have been awarded federal funds under the HITECH Act. Out of the 234 HIEs, 199 responded to this year's survey from eHealth Initiative, an advocacy organization. Respondents included 48 of the state entities.

Washington-based eHealth Initiative conducted the survey in June and July. Results show that 73 HIEs now are operational, meaning they are transmitting data that is being used by stakeholders, compared with 57 operational in 2009. Despite increased funding in the past year for HIEs--including nearly $548 million in federal grants early this year to the 56 state-designated entities--sustainability remains an elusive goal for many. The state entities, for instance, must develop and get federal approval of a strategic operating plan before getting the HITECH funds, a task accomplished so far by a handful.

Among the 199 responding HIEs, 107 are not dependent on federal funding but only 18 of these initiatives broke even on operational income alone.

Thirty-three HIEs report their initiative is reducing the time spent on clinical administrative and filing tasks, 30 say their users are spending less time handling lab and radiology results, and 28 report decreased costs on redundant tests.

Addressing government policy mandates is a major challenge for 131 of responding HIEs. The complete report, "2010 Annual Survey of Health Information Exchange," is available at

--Joseph Goedert


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