I like to think that Massachusetts is at the forefront of health IT in the US (okay, okay, the truth is I'm seriously torn because I have a VERY soft spot for Indiana as well). But the news coming out of Minnesota is that they may soon be able to lay claim to top spot in health IT. According to Government Health IT News, the state of Minnesota has mandated: 1) electronic claims by Jan 2009; 2) e-prescribing by all providers serving state employees and their dependents by 2009; and 3) "interoperable EHRs" by all physicians and hospitals by 2015.
In order to get rapid change in this or any other industry, you need either strong economic incentives, strong regulatory compulsion, or a mix of both. The way US health care delivery (and reimbursement) is currently structured, incentives will probably only get us so far before we have to add in a bit of compulsion (or maybe, a lot of compulsion). The EHR mandate issue has come up before in Massachusetts. Given how broken health care delivery is today, I think a mandate is a good idea, but only if we inject funding and support to help physicians and hospitals to achieve the mandates effectively. Otherwise, we can mandate all we want, but we'll only get as far as the current system will allow us to go (ie, not far).
MAeHC estimates that it will take about $500M to get just the ambulatory side done in Massachusetts -- more if you want to include hospitals like the Minnesota mandate does. I haven't heard that Minnesota has provided much funding for their EHR plan ($14M for rural practices). Maybe Massachusetts' and Indiana's leading positions are safe after all......
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