Marchibroda: E-health work keeps pace

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More than 1,300 people joined us in Washington, D.C., last week for a successful Health Information Technology Summit.

Interest in the room was extremely high, beginning with the first general session, during which Mike Leavitt, secretary of the Department of Health and Human Services, punctuated his remarks with verbal snapshots of his encounters with victims of Hurricane Katrina at temporary health facilities in Louisiana. Dr. Frederick Cerise, secretary of the Louisiana Department of Health and Hospitals, joined us by telephone from Louisiana and spoke of the challenges that people there face.

Their firsthand accounts of the plight of those left homeless or displaced by the hurricane and the unforeseen loss of thousands of paper medical records underscored the need for an interoperable health information exchange.

The conference was a powerful forum to hear from leaders in health IT strategy, including Leavitt; Mark McClellan, administrator of the Centers for Medicare and Medicaid Services; Carolyn Clancy, director of Agency for Healthcare Research and Quality; Dr. David Brailer, national coordinator for health IT; Virginia Gov. Mark Warner; and Richard Granger, director general of the National Health Service in the United Kingdom.

The eHealth Initiative was delighted that McClellan unveiled a new program, the Medicare Health Care Quality Demonstration, as part of his summit presentation. The demonstration will test models of health care delivery system redesign and alternative payment models. A significant component of the redesign will likely involve the use of health IT. The eHealth Initiative applauds the call for proposals and CMS’ recognition of the link between health IT and health care quality and safety.

In our 2005 survey of community and regional health information exchange efforts, we found that about one-third of advanced-stage initiatives are moving beyond functions that directly support care delivery to chronic-care management and quality and performance improvement efforts. CMS’ program is designed to align financial incentives with these goals, seeking to improve quality while increasing efficiency through a major, regional-level health care system redesign. It also calls for project participants to use health IT as a facilitating tool.

That survey also shows that more than 100 communities nationwide are engaging stakeholders to mobilize health information across their markets. But one of the most difficult challenges for these efforts is sustainability. Payment incentives that reward quality, efficiency and system redesign efforts will support sustainable business models for local and regional efforts.

Go to for more information about the demonstration. For a copy of the eHealth Initiative’s recent report, “Emerging Trends and Issues in Health Information Exchange,” go to

Finally, the appointment of a 16-member federally chartered American Health Information Community begins a new collaboration toward mobilizing health information to support patient care. Five of the eight private-sector appointees represent organizations that are members of the eHealth Initiative. We look forward to a strong relationship with this public/private effort, which promises to advance the goal of interoperability.

Marchibroda is chief executive officer of the eHealth Initiative and Foundation.


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