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Brailer Gets Vote Of Confidence

National health coordinator is up for the challenge of using technology to improve the nation's health care, friends and colleagues say

If there's anyone who can lead the country's paper-burdened health-care system into the business-technology age, industry insiders say it's Dr. David Brailer.

Brailer was recently named the first national health IT coordinator, a position created by President Bush, who in May also set the goal of providing most Americans with electronic health records within the next decade. Brailer reports to U.S. Health and Human Services Secretary Tommy Thompson.

Brailer is, by all accounts, well-known and highly regarded in health-technology circles. Those interviewed for this story who have worked with him agree that his calm temperament combined with his training as a medical doctor, a Ph.D. in economics, and experience as a former CEO make him the perfect candidate to take on what's expected to be a challenging job. His peers describe him as professorial, a strong collaborator, and a keen listener.

In his new role, Dr. David Brailer, recently named the first national health IT coordinator, must bring together many fragmented segments of the health-care sector. Photo by Chris Smith of Health and Human Services.

In his new role, Brailer must bring together many fragmented segments of the health-care sector.

Photo by Chris Smith of Health and Human Services
In his role, Brailer must bring together the many fragmented segments of the health-care sector, including doctors, hospitals, health plans, payers, and the health-related agencies of the federal government. The goal is to improve the nation's quality of health care and reduce costs through the use of technologies such as electronic health records and electronic prescription-ordering systems. The U.S. government estimates that these types of systems can save $140 billion annually through improved patient care and the elimination of redundant tests ordered when doctors don't have access to paper-based information.

"A lot of nontechnology policy attempts to revamp health care and reduce costs have failed, and now the focus is on getting this done through IT," says Elliot Stone, executive director of the Massachusetts Health Data Consortium. "People like David Brailer will make this happen."

Still, the challenges ahead are daunting. It's estimated that less than 5% of physicians and hospitals use electronic health records and related systems, in large part because of the costs and cultural changes involved in implementing them. And sharing patient information, even among affiliated health-care providers and hospitals, has, for the most part, been rare because of disparate systems and lack of standards in everything from the medical terms used to describe illnesses to the technology itself.

All of these issues are challenges that Brailer has tackled before, most notably during his 10 years as chairman and CEO at CareScience Inc., a health-care-management company he co-founded and then left last year when it was acquired by software and services firm Quovadx Inc. At CareScience, Brailer designed and oversaw the development of the Santa Barbara County Health Data Exchange, the nation's first peer-to-peer electronic health-information data exchange, which lets hundreds of doctors, hospitals, and labs in Santa Barbara County, Calif., securely access patients' medical information, regardless of where the data is located.

"His vision for Santa Barbara in 1997 is what's happening in the industry today," says Lori Evans, VP and program director at industry coalition eHealth Initiative and former director of data-exchange services at CareScience. "He was really before his time." Interoperability issues, which were key in the Santa Barbara County Health Data Exchange, will likely be a strong area of focus for Brailer in his new role, Evans says.

Brailer is likely to remain in the new job regardless of who occupies the White House come January, Stone says. The government's intensified focus on health-care technology is no passing fancy, he says. "This is absolutely beyond politics. Everyone gets this."

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