Health IT Czar's Abdication Won't Slow E-records Push

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May 01, 2006 (Computerworld) -- Users from the health care community last week said the resignation of the point man for federal health IT efforts shouldn't blunt ongoing moves to adopt electronic medical records nationally.

But they stressed that whoever replaces David Brailer, who resigned as national coordinator for health information technology late last month, must quickly show measurable progress in the e-health arena. The next coordinator must also foster closer collaboration between the government and doctors, users said.

President Bush appointed Brailer in May 2004 to help lead a national effort to replace paper-based health records with electronic medical records. Health care IT execs said Brailer was a high-profile advocate of EMRs and of creating the standards and infrastructure needed to exchange them.

John Wade, CIO at Saint Luke's Health System Inc. in Kansas City, Mo., said Brailer's departure nonetheless could speed the move toward a national health information network, prompting a shift from planning to action.

Brailer did a "spectacular job" of building awareness among Congress and the public regarding how much work is needed to create an EMR network, Wade said. "He's the one who had to be the standards advocate while at the same time navigating the political issues to gain and sustain momentum," Wade said.

Mark Frisse, a professor of biomedical informatics at Vanderbilt University in Nashville, said Brailer brought a human face to what were intangible issues. Through that effort, he said, "the health care IT horse is out of the barn, and sufficient consensus exists that rapid acceleration is possible."

Frisse, who is working to develop a regional health information organization in Tennessee, suggested that the next coordinator work to foster stronger collaboration among federal agencies.

"People want a coherent view of the federal government and a sense that agencies are working together," he said. "States are going to be critical in the next stage of evolution, and collaboration on state initiatives is important."

Frisse also said the new leader must continue Brailer's work on building a national health information network and on creating EMR technology standards.

J. David Liss, vice president of government relations and strategic initiatives at New York-Presbyterian Healthcare System in New York, said the new coordinator should have experience in a large-scale health care environment and credibility with the informatics community.

Brailer's successor must also ensure that the effort doesn't focus on the use of metrics to grade physicians' work or involve calculating payments based on such a grade, Liss said. The coordinator should instead work to streamline the health record process, he noted.

"Clinicians may view health IT more negatively if they perceive the technology's main function as aggregating and reporting data from their practices," he said. "This does not make the doctor's work easier; it merely supports another regulatory burden."

David Brailer

FIRST NATIONAL COORDINATOR FOR HEALTH IT Established the American Health Information Community — a 17-member panel representing large employers, technology companies and government officials — to foster the adoption of health IT nationwide. Awarded contracts totaling $18.6 million to four consortiums to develop prototypes for a national infrastructure to support electronic health records. Started programs to reduce barriers to privacy, security and interoperability that hinder widespread use of health IT. Announced a plan to start projects in biosurveillance, electronic health records, chronic care management and consumer empowerment.

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