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Integrated State Health Information Systems



Ben Steffen, Deputy Director for Data Systems and Analysis, Maryland Access and Cost Commission, Baltimore, MD.

Nancy Hoffman, Systems Development Administrator, Missouri Health Strategic Architectures and Information Cooperative (MOHSAIC), Missouri Department of Health, Jefferson City, MO.

(Walter) Pete Bailey, Chief, Health and Demographics, South Carolina Budget and Control Board, Office of Research and Statistics, Columbia, SC.

In this session participants explored in-depth integrated health information efforts in three States: Maryland, Missouri, and South Carolina.


Ben Steffen provided an overview of Maryland's health care environment, reviewing Maryland's health maintenance organization (HMO) penetration, the increase in uninsured in recent years, and physician supply. He then examined State reform initiatives and opportunities, and explained that information integration was a theme of Maryland's initiative and that legislative support for data collection is strong.


Nancy Hoffman defined the Missouri Health Strategic Architectures and Information Cooperative (MOHSAIC), and then demonstrated electronically how it works. She outlined the following critical factors to implement an integrated health information system successfully:

  • High level support.
  • The authority to act.
  • Centralized information systems resources.
  • Adequate funding.

South Carolina

After defining an integrated system, Pete Bailey cited a number of benefits of online, retrospective systems. Specifically, these systems can:

  • Integrate retrospective views by client across programs.
  • Support studies of the demographic and social characteristics of people who use or do not use services, their outcomes and risk factors.
  • Analyze the comparative outcomes of providers and case managers.

Mr. Bailey also reviewed some of the data South Carolina has collected and analyzed and made a strong case for the importance of intra-agency integration. On gaining support for building a system, he shared the following thoughts:

  • Be fair.
  • Come to the table without an agenda.
  • Do not seek to control.
  • Do not ask for money.

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