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Integrated State Health Information Systems

Coordinating Information to Address State Health Policy Needs

Competition & Cost Management


Gerald O'Keefe, Director of Health Data Policy, Massachusetts Division of Health Care Finance and Policy, Boston, MA.


Donald Nielsen, M.D., Associate Medical Director, Kaiser Permanente, Oakland, CA.

This session explored the kinds of information that States need to evolve as purchasers of health care.

Jerry O'Keefe described the public-sector and market environments that are driving the development of information systems. He gave some examples of efforts currently underway in Massachusetts.

Dr. Nielsen added the health plan perspective and spoke of the dilemma of having to balance effectiveness, efficiency, and competitive advantage against cost, strategic advantage (does it pay off?), and the fear of technology change. He described how States might promote the development of private-plan information systems to serve public purposes in competitive health care markets:

  • By promoting public-private and public-public partnerships.
  • With economic incentives.
  • Through regulatory mechanisms.
  • With legislative remedies.


Physician Payment Review Commission. 1997 Annual Report to Congress, "Issues Concerning Data Reporting by Health Plans," Chapter 8, 1997, pp. 161-76.

Council on Competitiveness. Highway to Health: Transforming U.S. Health Care in the Information Age, Executive Summary, 1996, pp. iii-x.

Healthcare Information and Management Systems Society. Guide to Effective Health Care Clinical Systems, "Trends in the Cost Justification of Clinical Systems," Chapter 3, 1996, pp. 13-20.

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