UPI Story on HIT Calls on Marchibroda
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By ALEX CUKAN |
August 10, 2005 |
HHS 'czar' to jumpstart health IT
ALBANY, N.Y., Aug. 10 (UPI) -- Part 6 of an occasional series. One of the main reasons healthcare has lagged behind all other U.S. industries in becoming computerized is because of the way it is organized -- it is a decentralized system with a lot of waste and redundancy.
According to Dr. David Brailer, the national coordinator for health information technology, one of the big debates in healthcare today is whether those regional IT differences are creating difficulties so severe there should be an effort to eliminate them.
"A lot of regional healthcare differences across this country are the result of culture, religion, ethnic makeup and geography," Brailer told United Press International.
Patients might assume that treating a disease in Boston would be identical to treating it in Seattle, but it might not be, he explained. There is no centralized "way of doing things" or system for communicating among doctors of one patient, because medicine as practiced by more than 700,000 doctors nationwide generally has been run as a cottage industry.
As a result, hospitals and doctors may not communicate with one another and patients may be subject to redundant tests and procedures because each doctor orders them on his or her own and the results often are not shared.
Brailer was named the first U.S. national health IT "czar" in May 2004. His task is to encourage doctors, hospitals, vendors, healthcare-insurance providers, laboratories and government agencies to work together and move toward the goal of computerized medical records and evidence-based medicine -- basing treatment options on the latest research findings published in the medical journals.
On April 27, 2004, President George W. Bush signed an executive order creating the position of national coordinator for health information technology, within the Department of Health and Human Services, charged with pushing forward the widespread adoption of health information technology within the next 10 years. The goals including lowering costs, reducing medical errors, improving quality of care and providing better information for patients and physicians.
Brailer hit the ground running. One month before being appointed, in testimony before the House Ways and Means Subcommittee on Health, he outlined his objectives.
"The president's vision is to develop a nationwide health IT infrastructure that ensures appropriate information is available at the time and place of care, resulting in improved healthcare quality (and) fewer medical errors -- and (it) may even reduce healthcare costs," Brailer told legislators.
"This new infrastructure will help to connect physicians, hospitals and consumers in every location of our country," he testified. "This would give consumers and clinicians secure and controlled access to all the important information they need to make informed decisions about their health and healthcare, while ensuring individually identifiable information is confidential and protected."
Over the past year Brailer has held numerous meetings with all of the health IT stakeholders, as well as the HHS's National Committee on Vital and Health Statistics and the Commission for Systemic Interoperability established by the Medicare Modernization Act.
He also has met with delegations involved with health IT from Canada, the Netherlands, Japan, Australia, Great Britain and France to learn from their experience.
Last month HHS called for nominations for the American Health Information Community, a public-private collaboration to help develop standards and achieve interoperability of health IT. It will help provide a forum for public and private interests to recommend specific actions to accelerate the widespread application of health IT.
In addition, Brailer published a Request for Information in November 2004 soliciting public input on how a Nationwide Health Information Network could be developed. His office received more than 500 responses and compiled a summary document.
He called that document "the richest and most descriptive collections of thoughts on interoperability and health information exchange that has likely ever been assembled in the United States," in testimony before the Senate Commerce, Science and Transportation Subcommittee on Technology, Innovation and Competitiveness last June. "As such, it has set the foundation for actionable steps designed to meet the president's goal."
In fact, few things in the federal government have moved so quickly.
It may appear that the federal government decided to address health IT when Bush mentioned it in his State of the Union Address in 2004, but it took stakeholders years in and out of government to move the issue onto the president's agenda.
"It was private efforts, Congress and some in the administration passionate about the benefits of health IT that resulted in the government making it a priority," Janet Marchibroda, chief executive officer, eHealth Initiative, a non-profit group based in Washington, told UPI.
Next: Costs, savings, regions and medical errors
Alex Cukan covers medical business and personal health matters for UPI Science News.
