Colorado’s 4th Health IT Roadmap Builds on Earlier Iterations
During a recent webinar hosted by HIMSS, leaders from Colorado’s Office of eHealth Innovation described the latest iteration of the state’s health IT roadmap, which they said is about transforming care through collaboration, improved data sharing and community-led solutions.
The Office of eHealth Innovation (OeHI) resides in the office of Lieutenant Governor Dianne Primavera, who participated in the webinar. She said the state seeks to “use health IT as a bridge, not just between systems, but between people and the care they deserve, whether that's through access to telehealth or secure sharing of data between providers and community organizations. The roadmap helps put that vision into action.”
Zooming out from health IT efforts at first, Primavera said Colorado Gov. Jared Polis created the “Office of Saving People Money on Healthcare” at the beginning of his first term to address the high cost of healthcare, and Primavera serves as the director of that office.
She said they work to ensure Colorado is a model for how cross-sector partnerships can translate into better outcomes for people. It brings together agencies whose mission is integral to healthcare coverage and delivery in the state. They include Department of Health Care Policy and Financing, the state Medicaid agency; the Department of Public Health & Environment; the Division of Insurance; the Department of Human Services; and the Behavioral Health Administration. This group has developed what they call “wildly important goals” or WIGs, she explained, and those are developed and monitored in coordination with Primavera’s staff.
“We want to save an additional $1.6 billion to reach $3.5 billion in healthcare savings throughout the Polis-Primavera administration by increasing efficiency and lowering the cost of healthcare,” she said. “We want to decrease the percentage of emergency department visits to Colorado hospitals from uninsured patients from 10% to 7% by June 30, 2027. We want to credential an additional 7,000 entry-level health workers by providing no-cost education through our Care Forward Colorado program and Career Advance Colorado for a total of 14,000 people by June 30, 2026.”
Primavera stressed that an intentional and interagency approach is vital to break down historic barriers and silos. This roadmap, she added, aligns with all of those areas and is built to support population health but also economic mobility and digital access.
Stephanie Pugliese, M.P.H., director of OeHI, said that in support of these goals, her office develops policy, funds pilot programs and coordinates efforts across the state. “We work with providers, patients, payers, community organizations and agencies, and we see ourselves not just as policymakers, but as problem solvers, finding ways to integrate technology that works for people all day every day,” she said.
Turning ideas into outcomes
Over the past eight years, OeHI has turned ideas into real outcomes, Pugliese said. “Past roadmaps helped launch initiatives like the Colorado Telehealth Network, the Rural Connectivity Program and the Colorado Social Health Information Exchange, all of which have changed the way Coloradans access care and connect to services,” she said. “We’ve helped shape legislation, funded statewide pilots and guided cross-agency data integration. Noting that the roadmap has evolved over the years, she said it isn't just aspirational, it's actionable.
OeHI was founded in 2015 and the first roadmap was released in November 2017, so the 2025 health IT roadmap is Colorado’s fourth.
“We have been building on those years of lessons at each iteration,” Pugliese said. “This version is more focused, more responsive and much more inclusive than ever before. We streamline the document to about 30 pages, focusing on implementation, not theory. Each roadmap has probably been about half the size of the one before it, so we are paring down quickly. It's based on feedback from more than 30 listening sessions, and is tightly aligned with statewide affordability and access strategies.”
In those meetings, they weren’t just looking for feedback, Pugliese said. “We were funding organizations to lead those discussions. We offered stipends, translation and tech support to make sure every voice could be heard. Ultimately, we centered the strategy on meeting people where they are, in understanding how we can all best move forward together.”
Throughout the development process, they receive feedback from fellow state agencies, healthcare providers and staff and individuals. “We would also hold listening sessions with our internal state agencies to make sure that they're aware of the feedback that we're getting, whether it's relevant to health IT or not,” Pugliese added.
Primavera said that in listening sessions one message was clear: “Grant processes are too complex. Providers need better support, and broadband is still a barrier. The answer to this is interoperability, to make sure that systems talk to one another, that data is secure and that patients get exactly what they need.”
The roadmap details some recent OeHI efforts on the interoperability front:
• In partnership with the Government Data Advisory Board (GDAB), developed and enacted the state agency data-sharing agreement template to streamline internal sharing of data.
• In partnership with the Office of Information Technology (OIT), expanded the Identity Cross-Resolution Service (IDXR) across eight state source systems to link individual records.
• Developed the foundation for a consent management proof of concept solution and are planning to integrate the solution into the Colorado Social Health Information Exchange (CoSHIE) unifying architecture.
• Launched feasibility assessment for a centralized consent repository to support improving data-sharing foundations across Colorado as outlined in House Bill 24-1217
Pugliese said that in listening sessions, across the board people said they want simpler, more unified systems. “Data sharing, consent and language access came up again and again, especially when it comes to connecting medical and social care. So our goals reflect these conversations.”
The first goal is to enhance community engagement in health IT solutions. “We want to support secure and appropriate sharing of data. What we heard that surprised me is there was a lot of desire for guidance around data standards. That's something that our office is going to be working very closely with our eHealth Commission on,” Pugliese said.
She added that OeHI also seeks to foster responsible innovation. “Colorado has a really neat innovation ecosystem, both focused on health technology, and on a number of other technologies, too, and we really want to support and nurture that environment while ensuring that these innovations are not causing unintended harm to any populations that they're intended to help,” Pugliese said. “We're funding data pilots, improving consent tools and building language access. From day one, it's all about lifting up the systems that already work and not replacing them.”
Primavera said one of the biggest advances is the Colorado Social Health Information Exchange (CoSHIE). It enables technology to shoulder the burden of connecting healthcare providers and community-based organizations to better serve whole-person needs. “COSHIE is designed to be invisible to the end user. So for providers, it just means more useful information, fewer silos and better referrals. We're working to bridge the silos, not only in our state agencies, but in our health technology as a whole.”
Another initiative that has grown and evolved through a few of the roadmaps is the rural connectivity work. Through that initiative, they have funded rural providers to connect to the statewide health information exchange, developed a tailored rural analytics platform, and they are now working on a data mapping project to understand where they can streamline reporting for providers to various agencies for the State of Colorado. They are also rolling out public health data modernization and broadband mapping tools to fill gaps and increase trust in the system.
Pugliese said that as they implement the roadmap, the eHealth Commission will continue to provide feedback. “Their leadership ensures we stay on track and stay connected to the voices of patients, providers and communities across Colorado.”
