Mississippi wants to build a statewide health data network. It’s been here before

Mississippi is again working to build a statewide system that will help hospitals, health providers, pharmacies, laboratories and emergency medical services securely share patient health data.

“We’re creating the infrastructure to improve care coordination, to support emergency preparedness, to strengthen public health decision making and to give healthcare professionals the information that they need to deliver even better care,” Gov. Tate Reeves told reporters at an Oct. 21 press conference.

The exchange will initially be funded by the federal Rural Health Transformation Program, a $50 billion, five-year program to spur innovation in rural healthcare and offset cuts to Medicaid that was signed into law in 2025 by President Donald Trump. Reeves has called the health information exchange the “backbone” of the state’s plan for the funds. 

Health information networks help to create a “person-centric” health record system, where health records are linked to a patient rather than a hospital or clinic, according to Dr. David Kendrick, chair of the medical informatics department at the University of Oklahoma School of Community Medicine. 

“It should be expected that patients have their full medical story with them throughout life,” said Kendrick, who is also the the founder and former CEO of MyHealth Access Network, Oklahoma’s statewide health information exchange. 

This is not the first time Mississippi has worked to develop such a system. The Mississippi Health Information Network was funded with a federal grant and established by state lawmakers in 2010. It was growing until the state Legislature declined to renew it in 2019 — an abrupt decision stakeholders said came as a surprise.

Other health statewide exchanges emerged to fill the gap around the time the state network shut down, including the Mississippi Hospital Association’s IntelliTrue and the Mississippi Health Access eXchange, a physician-led network established in partnership with the Mississippi State Medical Association.

The federal government has pushed states to improve healthcare data sharing among providers for decades. The efforts can help bridge parts of a fragmented healthcare system and improve patients’ health, allowing clinicians across systems to spot dangerous prescription drug interactions and reducing duplicate services.

But despite the benefits for patients, health information exchanges, or HIEs, often face challenges with funding and incentivizing providers to participate, said Julia Adler-Milstein, a professor of medicine at the University of California-San Francisco.

“Building a successful HIE requires not just technical infrastructure, but governance, incentives, and a lot of pieces that have to come together and align for an exchange to be successful,” Adler-Milstein said.

In some states, expanded health data sharing has raised questions about patient privacy, in particular because of cases in which patient data has been used by immigration and law enforcement agencies. 

Mississippi’s application for a vendor to create and operate a new health information exchange, with services expected to begin in January, closed on Nov. 3. 

The contractor is expected to build and operate an exchange that “aggregates, enhances, and distributes health data as a public good,” according to a request for proposals. Core goals are to improve care coordination in trauma response, access to clinical information and centralized imaging services. Beyond serving individual patients and providers, it will also support the state’s study of public health. 

“It’s a game changer for those of us studying population health outcomes,” State Health Officer Dr. Dan Edney said at an Oct. 14 Board of Health meeting. 

How Katrina spurred Mississippi’s first exchange

Plans for a statewide health information exchange in Mississippi were spurred in 2005 by Hurricane Katrina, which damaged paper-based medical records and left thousands of patients unable to access them.

In 2007, then-Gov. Haley Barbour established a task force to plan for a statewide health data exchange. The group recommended a pilot network in the six-county area along the Gulf Coast most heavily affected by Katrina to lay the groundwork for a potential statewide network. 

State lawmakers authorized the Mississippi Health Information Network in 2010. That year, Mississippi received about $10.4 million in funding through a federal program to help states build health information exchanges.

Mississippi’s network generated a repository of patient data and sent real-time alerts to providers when patients were admitted, discharged or transferred to or from emergency departments or hospitals. It also supported public health reporting and disease surveillance efforts, said Mike Garcia, the network’s former interim executive director who was involved in the project from its early days and has since retired. 

By 2014, the system included 13 hospitals, 39 clinics and more than 600,000 patients, according to a report from the Joint Legislative Committee on Performance Evaluation and Expenditure Review.

But as it grew, the system struggled to achieve buy-in from some key stakeholders. Like many health information exchanges, providers paid a user fee to participate, with the expectation that the network would one day become self-sustaining. Hospitals were charged $100 per bed to participate, according to budget documents for the 2017 fiscal year. That year, the agency collected roughly $660,000 in user fees. Federal funding ran dry and legislative appropriations declined over time. 

Sen. David Blount, a Democrat from Jackson, authored the bill necessary to reauthorize the network in 2019 — what he believed would be a “routine matter on something important and needed.” 

The Senate passed the bill, but it died without a vote by the full House.

“To me, it was a needless failure, and I was puzzled by it at the time,” Blount said. 

When the Mississippi Health Information Network lapsed, it had roughly 30 million patient records, Garcia said. He said the records were stored in a vault and immediately began to lose their value.

“It was all very anticlimactic,” Garcia said. 

Building demand before infrastructure

The challenges Mississippi faced in keeping a health information exchange alive — including funding and participation — mirror those faced by similar networks across the nation. 

Although data networks can help improve the quality of patient care, hospitals aren’t always incentivized to share information, because patient data is a key asset that ties patients to hospitals, said Adler-Milstein.

For an exchange to succeed, it must also create value for providers, such as helping them meet quality metrics tied to payments and motivate them to participate. 

“There aren’t really strong incentives to share patient data across competing health systems,” Adler-Milstein said. “So you really have to build the demand, and then build infrastructure that supports it.”

Exchanges also need sustainable funding models, Garcia said. He said he believes government support should incentivize providers to participate without making them pay to participate, particularly because they are already contributing value by supplying data. 

“The burden can’t be put on the users,” Garcia said. 

Under some Mississippi Rural Health Transformation Program grants, providers receiving funding are required to participate in the exchange. State officials have not explained how the system will be funded after the federal funds, which must be spent by 2032, are expended.

Shelby Wilcher, a spokesperson for Reeves, whose office is overseeing the plan, did not respond to a request for comment about the state’s long-term plans to fund the exchange.

During the application period for vendors, one potential contractor asked whether the Mississippi State Department of Health or the Division of Medicaid would require or incentivize providers to participate, and whether funds would cover the providers’ onboarding costs. 

In response, the state Health Department, which oversaw the procurement process, said it “can not speak for RHTP requirements.” 

Beyond funding and incentives, experts said, a successful exchange requires buy-in from stakeholders across the health system — including those who receive, deliver and pay for care. Those stakeholders must first come together to establish a shared vision for the exchange and ensure it provides value to everyone involved to ensure sustainability. 

“Governance is what comes first, and that means convening actual people that live in the community to do the work,” Kendrick said.