Iowa's Medicaid program is set to receive approximately $1.16 million in federal matching funds to help it plan for the implementation of electronic health records through ARRA's incentive program. A number of other states are also on the verge of receiving their funds, according to the Centers for Medicare and Medicaid Services (CMS).

It's critical for CMS to get ahead of the pack and get EHRs live in state Medicaid programs across the country. Many industry leaders believe that since the government passed ARRA it needs to lead and demonstrate best practices and meaningful use. This will require close coordination between CMS and the various state programs.

It also calls for state programs to do a thorough job from start to finish. The planning activities in which Iowa and later states will have to engage include completing a comprehensive analysis of the current status of health IT initiatives in their state. Iowa is also going to use the matching funds to determine whether to implement personal health records. The data that the states collect needs to expose any barriers to adoption and determine provider eligibility for the EHR incentive payments in order for the state to tailor a successful, long-term health IT program.

A lot is riding on these state programs. Critics of CMS have pointed to myriad health IT demonstration projects that haven't shown cost savings or improved clinical outcomes. In an interview about something else entirely, I didn't get a chance to follow up on one industry expert's passing comment about CMS' failed health IT projects, but I'd like to hear from others. What projects failed? What has CMS learned from these failures? Surely there is value there. And what of projects that have been successful? I'd like to hear from state programs that have implemented successful health IT initiatives. Those are the programs that CMS should look to as it hands out the ARRA EHR incentive program funds.

There are state programs that are far along in their implementation of EHR programs for their Medicaid recipients. CMS should hold a summit and have officials from these state programs offer best practices to states that are entering virgin territory with health IT. Many states already have formal organizations developing a statewide health IT vision. CMS should work with these organizations to leverage their resources for the state Medicaid programs.

Close coordination and open communication are so important as we head into 2010. The first milestone of achieving meaningful use is in 2011. It would be a big boost to ARRA supporters if CMS can point to a number of successful state Medicaid EHR programs. It would be an even bigger boost for CMS.