The concept of a nationwide network of interconnected healthcare information technology systems may turn out to be a pipe dream, but the best chance of success lies in local and regional initiatives, a top federal informaticist says.
Citing efforts to share clinical records among competing healthcare providers in Indianapolis, Seattle, Salt Lake City and a handful of other areas around the country, "the early results are very promising," according to William Yasnoff, M.D., HHS senior advisor on the National Healthcare Information Infrastructure project.
Yasnoff, who spoke Tuesday at the Healthcare Information and Management Systems Society's summer conference in Chicago, compares the NHII concept to the Internet.
"It is not a centralized database of medical records but is a network of interoperable systems," Yasnoff says.
However, for the infrastructure project to work even on the local level, the healthcare IT community needs to agree on a standard model for electronic medical records--including common terminology--and overcome problems with authentication of data and locating individual patient records, according to the longtime biomedical informaticist.
To this end, HHS is convening a summit June 30-July 2 in Washington to help develop an agenda for building the public-private infrastructure.
"There's no guarantee that this is going to succeed," Yasnoff says, noting that the Institute of Medicine first raised the idea of a nationwide healthcare IT network back in 1991 and that, more recently, Congress failed to pass healthcare privacy legislation and blocked implementation of unique patient identifiers.
HHS developed privacy regulations under HIPAA only because Congress did not. Congress denied funding for patient identifiers in 1999 in the face of a public uproar about personal privacy.
Yasnoff suggests that each local and regional health information network can create public trust by setting up privacy and confidentiality review boards.
However, Yasnoff says, "I think we'd better succeed or the healthcare system is in trouble. I'm cautiously optimistic."
HHS has estimated that a fully functional, national infrastructure could realize $400 billion a year in productivity gains--25% of total U.S. healthcare spending.
"I think the evidence for cost savings is positive. But even if the evidence were neutral, I still think we should be doing this for patient safety," Yasnoff says.