Executive Order 54

To Create the North Carolina Health Care Information
and Communications Alliance

WHEREAS, the provision of high quality health care to all residents is a desirable state objective;

WHEREAS, optimizing the use of health care resources is necessary for all residents to receive high quality health care at reasonable cost;

WHEREAS, state government has need of detailed, current information on the quantity, quality, content, and cost of health care services rendered in the State of North Carolina for purposes of policy development and implementation of health care reform;

WHEREAS, the technology to allow interactive and real time exchange of medical information is necessary to optimize the use of health care resources on a continuous basis;

WHEREAS, the public sector must work with the private sector to develop information, telecommunications and telemedicine technologies applicable to health care in all settings;

WHEREAS, the development of a statewide health care information and telecommunications network is the most logical next step in meeting these goals; and

WHEREAS, upon direction by me the Articles of Incorporation of the North Carolina Health Care Information and Communications Alliance, Inc., a North Carolina non-profit corporation, have been filed with the Secretary of State of North Carolina and the formalities of organization of said corporation have been effected;

NOW THEREFORE, by the power vested in me as Governor by the Constitution and laws of North Carolina, IT IS ORDERED:

Section 1. Establishment.

The North Carolina Health Care Information and Communications Alliance, Inc. (tile "Alliance") is hereby, established.

Section 2 Powers and Duties of the Alliance.

The Alliance shall be operated in the public interest exclusively for charitable, scientific and educational purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code (or the corresponding provision of any future federal tax law), including, without limiting the generality of the foregoing, to foster the development and implementation of a statewide health care information system for the purpose of improving the delivery, quality, accessibility and efficiency of health care services in North Carolina by utilization of advanced information, telecommunications, and telemedicine technologies.

Solely for the above purposes, but not by way of limitation, the Alliance is empowered:

A. To research, test, develop and promote the optimum application of information, telecommunications, and telemedicine technologies to health care services in all settings;

B. To effect the on-going, development and implementation of open architecture, interoperable, integrated and interactive information systems in health care in all settings with fully articulated linkages to a statewide health care information network and with attention to national and international health care information systems and standards;

C. To effect the on-going design, development and implementation of distributed database management capability on a scale necessary to support a wide range of applications on the health care information network including, among others, clinical, emergency response, administrative, research and educational applications;

D. To foster development and installation of on-line standardized, computerized medical record and information systems in regional medical centers to enable utilization by remote providers of centralized diagnostic, treatment planning, expert consultation services, and medical reference, resource and training materials, with interactive question, answer and messaging capabilities;

E. To improve health care information systems utilized by participants in community-level health care delivery networks comprised, among others, of hospitals, clinics, physician and dental offices, group practices, emergency medical systems, nursing homes, home care services, pharmacies, company and school medical and wellness programs, social service agencies, medical, nursing and health administration schools, and telemedicine providers,

F. To assist small and remote rural hospitals, clinics, provider groups and other health-related organizations in becoming an integral part of the statewide health care information system;

G. To provide education and training in, and coordination with respect to, the use of information, telecommunications, and telemedicine technologies by health care providers, suppliers, patients, educators and public agencies;

H. To provide to the State of North Carolina and the United States federal government and other governmental units data and analysis for the purpose of health care policy development and decision-making;

I. To provide a mechanism for on-going evaluation of hardware and software performance, clinical effectiveness and administrative efficiency of the statewide health care information system and to provide a mechanism for feedback, redesign and upgrade of system capabilities;

J. To support the adoption and implementation of standards for computerized patient records and computerized patient histories;

K. To support clinical and health services research by providing confidentiality-protected patient histories and other information databases for use by qualified personnel;

L. To encourage the development of emerging businesses in the medical information, computer science, telecommunications, and telemedicine fields in North Carolina through research and education; and

M. To exercise all rights and powers conferred by the laws of North Carolina upon nonprofit corporations.

Section 3. Board of Directors. Consistent with the Articles of Incorporation of the Alliance, the members of the Board of Directors shall represent each of the following classes of members: (i) major medical centers; (ii) rural health care centers or organizations; (iii) telecommunications and information technology companies; (iv) pharmaceutical, clinical trial companies and health care applications device development and manufacturing companies; (v) other health care providers, local public health departments and nonprofit organizations; and (vi) persons who represent the interests of the State of North Carolina. The initial directors of the Alliance shall serve until their successors are duly elected and qualified as set forth in the Articles of Incorporation and By-laws of the Alliance.

Section 4. Chair of the Board, The Governor shall appoint the Chair of the Board of Directors of the Alliance to serve until the third annual meeting of members of the Alliance.

Section 5, Responsibilities of the Board of Directors in the First Year of Alliance Operations. The Board of Directors shall complete the following tasks in the first year of operations:

A. Review and, if necessary, refine the By-laws of the Alliance.

B. Take such steps as are necessary to apply for and receive certification as an Internal Revenue Code Section 501 (c)(3) non-profit corporation;

C. Identify initiatives to be undertaken immediately to effect the purposes of the Alliance and make arrangements to implement these initiatives;

D. Develop and adopt a six-year work plan for the Alliance, to be updated as necessary but no less than every two years;

E. Develop and adopt a proposal for staffing the Alliance;

F. Develop and adopt an operating budget for the Alliance;

G. Open Alliance membership to a range of health provider organizations and health care information technology corporations, each of which, by virtue of its research, experience, services and/or products, will bring to the Alliance assets and commitments necessary to achieve the goals of the Alliance as delineated in this Order and the Alliance's corporate charter; and

H. Establish the terms for Alliance membership, a fee schedule for membership participation in the Alliance, and other funding sources such that the Alliance will be self-sustaining and not dependent on government financing.

This Order shall be effective immediately and shall remain in effect until rescinded.

Done in the Capital City of Raleigh, this 1st day of July, 1994.

s/ James B. Hunt, Jr.


s/ Rufus L. Edmisten
Secretary of State