Health Care IT Czar: Industry Making Progress, But Has A Long Way To Go

Dr. David Brailer unveils plans to speed the health-care industry's adoption of electronic records.
The health-care industry is making headway in adopting IT that can help save lives and lower costs, but the industry still has a long way to go, said Dr. David Brailer, the nation's health IT czar, Thursday at a health-care event in Dallas.

"There has been great progress in the past year, and many are optimistic about the future of health IT. However, there is much more to be done, and we have to work to address real issues and barriers that will halt the remarkable progress that is being made," said Brailer, whose title is National Health IT Coordinator, in a speech to attendees of the Healthcare Information and Management Systems Society (HIMSS) conference.

To help continue that progress, the federal government this year has a number of initiatives planned, Brailer said. Those include the release later this year of a "strategic plan" or guide containing details needed for key stakeholders in the private and public sectors of the health-care industry to implement President Bush's vision for most Americans to have electronic health records within a decade.

The strategic plan was called for in the same executive order issued by Bush last spring that created Brailer's office of National Health IT Coordinator. The plan will focus on "building blocks" of electronic health-record adoption, IT interoperability, and streamlined federal health-information systems that together "are foundational for downstream efforts like personal health records and state-of-the-art bio surveillance," Brailer said.

Brailer also said that work by a new Certification Commission for Health IT--which is made up of health IT leaders from the private sector--remains on track to develop by the summer standards for E-health-record products in ambulatory settings. The certification standards will help physicians and hospitals know which products meet key industry standards before they make health-care IT purchases.

In addition, Brailer said a new review task force, comprised of more than 100 people from 17 government agencies, including the Departments of Homeland Security, Defense, Veterans Affairs, Treasury, Commerce, and Health and Human Services, is working to produce a summary and "meta-analysis" of the 500-plus responses--totaling 5,000 pages--that Brailer's office received last month from the health-care community in response to his request for information on how best to develop a national health-information network for sharing E-health records.

The task force's analysis is likely to take several more weeks, Brailer said. However, some common themes have emerged in the responses, including recommendations that the federal government not impose an "all-size-fits-all" solution to clinical data sharing, and that regionalized approaches to overseeing health data-exchange networks are preferred.

Privacy also was a topic in nearly all of the responses, with emphasis on how a national health-information network should ensure that patients have control over who has access to their personal health-care data, Brailer said.

The respondents also suggested that interoperability standards and policies for a national health-data network need immediate attention from the federal government, as well as private and public sector participants, to avoid silos of clinical data that cannot be shared.

While Brailer spoke on Thursday on how the health-care sector can continue to move toward widespread IT adoption, several private health-care players this week also detailed their own steps in that direction.

On Thursday at HIMSS, GE Healthcare, a division of General Electric, and Intermountain Health Care, which operates a health plan, 21 hospitals, and 100 clinics in Utah and Idaho, announced a collaborative effort valued at $100 million to develop best practices-based clinical software.

The software will be embedded in GE's Centricity electronic health record bedside decision-support applications based on Intermountain's best clinical practices.

The software will be rolled out to Intermountain facilities over the next five years, and also will as sold to other health-care providers. Intermountain senior VP Greg Poulsen says his company will receive royalties for those sales, but that wasn't the primary motivator in Intermountain's involvement. Rather, Intermountain's goal is to help accelerate the adoption of clinical IT tools industrywide.

GE Healthcare president and CEO Vishal Wanchoo says the co-developed software will serve as "a building block" for the industrywide adoption of clinical IT. He says industry estimates show that in the developed world, including the U.S. and Canada, only 15% of physicians have adopted clinical IT systems.

"Our work together has the potential to do for health care what the Internet did for research," Wanchoo says. "Information will no longer be tied to a physical location, like in a book or at a local library, but will be available in seconds on a computer, to anyone, anywhere," he says.

Hill Physicians Medical Group in San Ramon, Calif., is among the relatively few but increasing number of physician groups in the U.S. that are investing in clinical IT solutions to improve patient care and boost process efficiencies.

Hill Physicians, which is one of the largest medical groups in the U.S., with 2,600 independent doctors treating more than 400,000 patients in Northern California, plans to begin in March a multiyear rollout of integrated E-health record and practice-management systems from NextGen Healthcare Information Systems Inc. and application integration software from SeeBeyond Technology Corp.

While Hill doctors aren't mandated by the medical group to adopt the systems, Hill CIO Craig Lanway says he believes most will choose to do so, in part to keep up with the quality of care offered by their peers in the group, as well as to help improve inefficient processes.

Many of the doctors and their office staffs "are overwhelmed by paperwork," and the digitization of patient's clinical records and other paper-based processes can improve care and workflow, he says.

Although details haven't yet been worked out, Hill physicians who adopt the E-record and practice-management software will pay a monthly subscription fee and be able to take advantage of volume discounts from tech vendors working with the medical group, Lanway says.

Deployment teams consisting of Hill IT staff and representatives from the vendors will help each of Hill's approximately 1,300 doctor offices roll out the new systems, he says.