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Q&A: Blumenthal Talks EHRs, Healthcare Reform

President Obama's former national coordinator for health IT, Dr. David Blumenthal, shares his thoughts on progress with meaningful use of electronic health records, and what's next for healthcare reform.

InformationWeek: There's been a lot said about health information exchanges, and some doctors being resistant to the idea of sharing their patients' data with other doctors. But what do you think the feeling is among doctors about sharing their patient information more readily with the patients themselves?

Blumenthal: I think physicians have a lot of concerns about it, and I don't think most want to go to the trouble of doing this unless someone would make it possible to build in protections to prevent patients from getting information that could be very damaging if it's not explained, some things that are very important but need to be put into context. So, most information sharing systems that now exist do not share pathology results, for instance, because you don't want to learn you have cancer from a report. Most systems say they'll share information with patients within 48 hours, except for some information that will be shared after a week, which gives the physician a chance to catch up.

InformationWeek: In your work as national coordinator, what was most challenging and what are you most proud of?

Blumenthal: I think I was proud that we got the Meaningful Use program launched. It's not perfect and people will continue to find problems with it and make suggestions for improvements. But it was good enough to get us started. In some ways, the tight time was somewhat helpful because we had so much to do, and you know it all couldn't be perfect. I was pleased that we got a lot of other programs up and running, and we'll see how well they do.

I was pleased that we set up Office of National Coordinator in a way that seems to support these programs, and earn the respect of people in the Dept. of Health and Human Services and made it credible to the outside world. The challenges--I never felt like I came across a challenge that was so severe that it was capable of undermining the entire program, but there were many challenges. Finally getting agreement on the Meaningful Use regulations inside the administration was a challenge. There was a lot of education to do, a lot of discussion, and a lot of compromise. Another challenge was managing the critique of it.

I would say communicating to the professions and to the institutions was another important challenge. I knew intellectually how important communication was but I came to understand it in a very visceral way. I don't think people think of the technology project as being reliant on a communication program, but believe me it was and is. In that context, I had to make sure we were above criticism in terms of the objectivity, in respect to the industry and different professional groups, so managing the press was an important challenge, too.

InformationWeek: Did you meet with President Obama about the programs?

Blumenthal: No, I met with all the people around him.

InformationWeek: What was it like to be part of that time in the administration?

Blumenthal: I enjoyed it enormously. A lot of the energy was focused on health reform, which we were busy implementing with our programs, and other people were working on and managing health reform in the administration and in the Capitol. It was very exciting to be part of that environment and watch it evolve. At the same time I had relatively protected space with a set of responsibilities that was already established and approved so I felt that I had a very privileged, protected area of responsibility and a lot of opportunity to lead and to bring the administration along. It was a very fortuitous set of circumstances.

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