As the United States moves toward building a national health information network, a new report reveals that government officials disagree over the best way to ensure privacy.

	Health IT czar: We're on a route little traveled

The Government Accountability Office report concludes that, while the U.S. Department of Health and Human Services has a number of "collective initiatives" to address privacy, there's no clearly defined strategy to bring it all together. The GAO recommends that HHS define and implement a comprehensive approach to data protection.

HHS officials bristled, arguing the department already has a comprehensive plan and that "tightly scripted milestones" would impede its processes.

Dr. Robert Kolodner, interim national coordinator for health IT, reporting to Health and Human Services Secretary Michael Leavitt, tried to defuse the situation. "There's no disagreement that privacy and security be built in," he said in an interview. However, he acknowledges "honest differences of opinion" between the GAO and Health and Human Services, especially on the issue of milestones.

Kolodner thinks privacy milestones should be established as a health information highway evolves, so state and local governments and other stakeholders can weigh in. "I liken it to Lewis and Clark," he said. "During their journey, when they came across a mountain, they didn't know if there was another mountain or a river on the other side. This is a journey that no one has ever done before, as well."