When David Brailer outlined his blueprint for a national effort to advance health information technology last week, he did it against a backdrop of muscle.
Sitting behind him was a long row of directors or top representatives from nearly a dozen federal departments that collectively account for $900 million in annual spending on IT related to patient care and the know-how to show others how it's done.
Besides HHS Secretary Tommy Thompson to Brailer's right, the gathering included CMS Administrator Mark McClellan and the top healthcare directors in the departments of Defense, Veterans Affairs, Indian Health Service and the Office of Personnel Management, as well as directors of the Centers for Disease Control and Prevention, Food and Drug Administration and National Institutes of Health.
Brailer called it an "unprecedented assembly of federal leadership," and it was evidence that his first 76 days as national IT coordinator had as much to do with getting the top-level support of federal government agencies as it did articulating the beginnings of a national strategy to move the public and private sectors toward nationwide adoption of health IT.
"We started the job at HHS, we've worked (in the public sector) to develop standards (consensus) and lay the groundwork," said Thompson. "And there's good leadership in the private sector as well. But the two never meet-or when they do meet, they don't talk the same way. ... These efforts need to be brought together and coordinated with very much a unifying strategy."
Brailer laid out four broad goals for all industry movers to rally around: informing the clinical practice of medicine, interconnecting clinicians, personalizing care for consumers and improving population health.
Informing clinical practice includes bringing IT to the point of care, especially through investment in electronic records in physician offices and hospitals, he said. Incentives to be reviewed include regional grants and contracts, improving availability of low-rate loans, using Medicare reimbursement to reward the use of electronic records, and testing new concepts whereby Medicare pays for performance-linking payments to quality of care rather than volume of services only.
A special panel to be appointed by Thompson will report by October an assessment of the costs and benefits of health IT to the industry and society. The panel of executives and leaders is expected to solidify options for incentives that the government will pursue in collaboration with the private sector, a spokeswoman for Brailer said.
To further efforts to use data-exchange standards effectively, HHS will seek information this summer on how to form a consortium of technology companies to plan, develop and operate a health information network.
The consortium would start with identified standards for easy exchange of data from one computer system to another, or interoperability, and begin to "operationalize" the standards consensus so it works in practice, Brailer said. "Interoperability is a great concept," he said, "but it's not much of a reality."