We're making some progress toward building a national health care infrastructure. But it remains painfully slow going, in part because of the scope and complexity involved, and in part because of politics and other agendas.

Just last week, the House of Representatives passed a bill to make permanent both the post of national health IT czar and a committee to shepherd national interoperability standards. Both were originally established by President Bush, and the idea is to make them last long after he's out of office.

This is all good, as the kids say, but in the meantime there's another bill in the Senate that's a slightly different version of the House bill, and that needs to be reconciled with the new House bill. Among the differences is a quality provision in the Senate bill; the House bill also provides $30 million in grants for the implementation of electronic health record systems. Some insiders believe this will happen in time for President Bush to sign the whole works into law sometime this fall. We'll see.

Adding fuel to the political scene is the relatively recent involvement of mainstream IT vendors. In the past few weeks, Microsoft acquired hospital-developed software as part of a major health care push, and Accenture has announced a lab to develop applications based on service-oriented architecture for health care providers (and financial services firms).

These are welcome developments because the involvement of traditional computing vendors will undoubtedly bring more integration between the world of health care applications, traditionally a niche occupied by very specialized providers, and the IT infrastructure at large. On the other hand, we all know what can happen when you add more vendors to the fray from a customer service point of view. 'Nuff said.

Meanwhile, the post of the aforementioned national IT czar has been vacant since April. Dr. David Brailer held the job for two years and helped establish a lot of the groundwork toward a national health care agenda. Brailer resigned due to family and personal issues, telling one publication the weekly commute from his home in San Francisco to Washington D.C. was particularly grueling. He brought together many of the different stakeholders to start talking about what needs to be involved from technology, policy, and privacy perspectives and helped get things rolling.

But his resignation was announced four months ago, and his successor is overdue to be named. Otherwise we risk losing momentum, and this is too important.

As a former emergency medical technician, I can attest to how accurate information, delivered quickly, really does help save lives. And just last week, an acquaintance of mine died at the age of 48 because she was given a drug to which she was allergic. (Yes, it was on her chart. Apparently some human error intervened here.) Given all the tools and technology available, this should never have happened. I'm hopeful that a national health care tech infrastructure can stop this sort of preventable tragedy--at some point in the future.

On a brighter note, the national health care standards group is also making some progress. On July 18, the Certification Commission for Health Information Technology gave its stamp of approval to the first round of e-health products, 18 in total. This commission was created two years ago to develop and evaluate the certification criteria and inspection process for the interoperability, functionality, and security of three major types of health IT.

Additional certifications are coming soon, possibly even by today.

These are all important moves, and I congratulate everyone involved, but I worry it's all taking too long. Those of us in the IT industry know about the sometimes protracted and political process of how long standards can take to develop, and how important they are as the underpinnings of anything that's to last and be useful in the long term.

But even as you read this, individual health care providers, geographic regions, and states have their own e-health initiatives going on. There are dozens of projects, if not more, and I worry the longer the federal infrastructure takes to define itself, the more divergent all these efforts will be. We don't even have a working national definition of what information a health e-record should include, no less the format it should be in, or how individual doctors, hospitals, and insurance companies will be able to access the information with different systems and business processes.

Also, a new type of privacy worry has surfaced regarding e-health: identity thieves can use stolen identities to obtain drugs, treatment, and even surgery, leaving their victims not just in debt, but also with false records at hospitals, doctor offices, pharmacies, and insurance companies. It's moving way beyond the stage of someone you don't know, no less gave permission to access your records, finding out about that tonsillectomy back when you were five years old.

And finally, according to a survey back in February, turns out most consumers are completely unaware that the federal government is on a mission regarding e-health records. According to an IDC study in February, 70% of consumers didn't know this was happening.

And so I wonder, are we moving as quickly as we should be? Should we blaze ahead with all the dozens of projects, or should we wait until the appropriate national standards are set before any more major projects begin? What risks and rewards do you see here, as IT professionals? Sound off below.