The Healthcare Information and Management Systems Society (HIMSS) and National Association of State Chief Information Officers (NASCIO) formed a collaboration to determine how the State Chief Information Officer (CIO) views the current health information technology landscape. Specific areas of focus for this study included Medicaid Management Information Systems (MMIS), Medicaid Eligibility Systems, Data Governance and Identity Management, State Level Health Information Exchanges, Shared Services and Collaborations. This study combined HIMSS’ expertise in health information technology and information exchange with NASCIO’s expertise representing state CIOs and information technology executives from the states, territories and the District of Columbia. The results of this collaborative survey will serve those seeking to understand the current environment of State healthcare technology initiatives ranging from governance models to data exchange activities. This analysis will also facilitate understanding of the intersection of the state CIO’s role with state health information technology (HIT) projects. This collaboration represents one of the first holistic analyses focused on the state CIO perspective of State HIT projects.