Health IT moves to actions

Mike Leavitt, secretary of the Department of Health and Human Services, managed last week to move the development of U.S. electronic health care systems from the talking stage to something close to reality, executives of health information technology advocacy groups, vendors and systems integrators said.

But the development of a nationwide electronic health records (EHR) system needs a lot of spade work and will require a mammoth amount of public and private investment before Leavitt’s vision becomes reality, they added.

Mark Roman, a vice president and global health care leader at EDS, said the planned formation of a public/private American Health Information Community (AHIC) to spearhead EHR development along with the release of request for bids on health care networks and standards has moved “health care IT beyond the PowerPoint stage.”

Janet Marchibroda, chief executive officer of the eHealth Initiative, a Washington, D.C., e-health policy group, and executive director of the Foundation for eHealth Initiative eHealth Initiative, said Leavitt’s decision to lead the AHIC shows that he recognizes health care IT's importance and the need to have a public/private partnership to drive deployment and adoption of EHR systems, standards and networks.

Neil de Crescenzo, health care leader of IBM's Business Consulting Services, echoed Marchibroda. He said it is significant that Leavitt decided to make a personal commitment to health care IT by assuming leadership of AHIC.

Despite this high-profile leadership, health care IT in the United States remains woefully underfunded compared with other countries, Roman said. The $85 million in health IT funding that Leavitt announced last week “is a pittance” compared with the $20 billion the United Kingdom plans to spend in the next decade on its National Health Service Connecting for Health project. The project will deploy EHR systems throughout England.

Dan Garrett, vice president and managing partner of Computer Sciences Corp.'s Global Health Solutions Division, said such the United States does not need -- and probably could not wisely use -- such a staggering sum right now. “We need to put the process and standards in place and develop architectures before such hard-core dollars are needed,” Garrett said.

He said the United States needs to develop logical and physical architectures that determine the integration between computer and physician and among physicians and other providers, including clinics and hospitals.

Dr. Richard Pico, chief medical and technology officer in Perot Systems' health care division, said development of a data management service that can handle the interchange of files from numerous EHR systems -- estimated by HHS to number more than 200 -- needs to be developed, installed and tested in prototype national health information networks out for bid by HHS.

Pico said such a data management service needs to be designed to extract critical elements from disparate EHR systems, including fields dealing with medications and allergies, and then transmit them via the health IT network, where they can be easily extracted.

Charlene Underwood, director of government and industry affairs at Siemens Medical Solutions and chairwoman of the Healthcare Information and Management Systems Society's EHR Vendors Association, said that besides focusing on data standards such as Health Level 7 messaging standards, the health care industry, AHIC and HHS also need to focus on developing a common language for medical procedures and diagnoses. “We need to focus on semantic interoperability” as well as data interoperability, Underwood said.

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