Robert Wah is no Jay Gatsby; hes not trying to re-create the past, but he knows what its like not having the money to make your dreams come true.
Wah, a physician informaticist, is now chief medical officer for Computer Sciences Corp. He served as first deputy to David Brailer when Brailer was named in 2004 to head the newly created Office of the National Coordinator for Health Information Technology.
Wah made a presentation on connecting huge private- and public-sector databases of healthcare information during the recent Healthcare Information and Management Systems Societys conference in Chicago.
When Wah moved over to the ONC, he had been associate chief medical information officer with the U.S. Navy, and it was like moving to another world. President George W. Bushs executive order that created the ONC in April 2004 also said that there would be no additional federal money appropriated to carry out ONCs work. Catching the drift, a Republican-controlled Congress zeroed out the ONCs first full-year budget, forcing HHS to shift money around internally to keep the ONC afloat.
I came from DoD with a $900 million budget, Wah recalled with a smile. I came to David and asked him, What do you have for money? He said, $60 million.
We were fighting for every dime, Wah said. We were facilitating market-based solutions. Its a whole different environment now.
Back then, words accounted for almost all of the stimulus in the ONC program, so there were even battles over expending words about IT promotion. Wah remembers feeling pretty good on the morning of the 2006 State of the Union address. I had three sentences in, and they sent me an e-mail. I had to justify one of them. As the day wore on, the IT references dwindled from three to two to one.
The whole story of how hard it is to get one sentence in the State of the Union is a whole other story, Wah said.
How would he grade the performance of the underfunded ONC on his watch?
I have a bias as to the grade you would give it, Wah said. It was inspirational and motivational. We raised the consciousness about this industry as effectively as we could with the resources available. We raised the national awareness of this issue in a very short period of time with a minimal amount of resources.
Wah likened it to a chemistry experiment. We were able to catalyze events; we were able to make them happen. I had my little crystals, and very little of them, and I had to judiciously put them in the water and help it turn blue.
The American Health Information Community, a federally funded healthcare IT advisory panel created by then-HHS Secretary Mike Leavitt in 2005 brought public- and private-sector leaders together in a highly visible process that was open and transparent, Wah said. Many people who know nothing about healthcare IT learned what it was and about its potential, he said. Now, My mom almost understands what Im talking about.
Wah said that he thinks it is an appropriate role for government to build the connectivity layer between healthcare organizations, but the $2 billion appropriated for the ONC in the American Recovery and Reinvestment Act of 2009 should be concentrated and not spread it like peanut butter across the country.
They dont have the bandwidth to manage 100 projects, Wah said. They ought to have some unifying principles, like demographic information, a clinical summary. Just the basics, not when you broke your foot in the third grade.