Brailer's untold ONC story: He wanted $17 billion for HIT

On April 27, 2004, President George W. Bush created the Office of the National Coordinator for Health Information Technology at HHS. The following week, then-HHS Secretary Tommy Thompson named Dr. David Brailer as the nation's first head of what was in those days referred to as ONCHIT, which was later reduced to ONC.

On May 19, 2004, Brailer delivered the keynote speech at the annual TEPR health information technology convention. It was likely his first public address as the nation's health IT “czar.” At least, that was how his job was sometimes described by the media in those days.

Six months later, Brailer's entire 2005 ONCHIT budget was zeroed out during congressional spending cuts.

What's not commonly known, however, is that Brailer had been advising the Bush administration on a bold new federal health IT policy initiative for more than a year before being named to head the ONC. A successful health IT entrepreneur with a doctorate in economics from the Wharton School, Brailer started wonking for the feds soon after his 2003 sale of CareScience, a Philadelphia-based healthcare analytics firm he founded.

Even lesser known and more surprising, given Brailer's libertarian leanings, was that he had asked for $17 billion to set up a national IT assistance program for providers. His initiative would have been different from the “Frankenstein created from our ideas” that would later emerge as the meaningful-use program, Brailer said recently.

His HIT funding plan was fiscally and philosophically dead on arrival, so Brailer soldiered ahead, deflecting numerous calls for federal IT support in favor of market-based initiatives, even though multiple surveys of providers in those days found that the high cost of EHR systems was the biggest deterrent to their adoption.

His 54-page white paper in April 2004, “Policy Options For Improving Health Care Quality and Efficiency Through Adoption of Interoperable Electronic Health Records,” written under contract for HHS, outlines where he thought the healthcare industry should go and what role the government might have in moving it in that direction. To read more on Brailer's conversation with Modern Healthcare, see our April 7, 2014 issue.

Follow Joseph Conn on Twitter: @MHJConn