Wednesday, February 16, 2005


Brailer Stresses Role of Community in Interoperable Health System by Caroline BroderiHealthBeat editor June 25, 2004
The government's health IT czar on Thursday emphasized the role that communities can play in creating an interconnected health care system. Community data exchanges are the key building blocks to a wired health care system and can help overcome some of the barriers to using information technology in a fragmented system, according to Dr. David Brailer, the government's health IT coordinator. Brailer, who spoke at the eHealth Initiative's two-day Connecting Communities for Better Health forum, is former chair and CEO of CareScience, a health care management company that helped develop the Santa Barbara County Care Data Exchange. The exchange allows health care organizations in the region to electronically share patient medical records and other clinical information. Brailer said the data exchange faced several challenges, including a funding crisis. He urged health care leaders to weather such difficulties and create "institutions that have lasting staying power." Community-driven health IT systems can help avoid a one-size-fits-all solution from the government, he said.The 2005 federal budget contains $100 million to support community-based groups in their efforts to share health information electronically. In addition, President Bush's April 27 executive order requires federal health programs to promote public and private adoption of interoperable health care technology. Brailer said he is unsure about the specifics of his office's health care IT plan, which he will announce July 21 during the National Health Information Infrastructure conference. In the meantime, the organization is busy cataloguing the health technology programs that currently exist in the federal government—a task that's never been done before, he said. His office also will seek the budgetary authority to scrutinize federal programs that are not helping achieve the government's health IT goals and use the government's purchasing power to ensure that it buys interoperable health IT systems.Brailer outlined four areas where his office will focus:
Transforming physicians' practices: Information technology in the ambulatory environment would lead to physician satisfaction and help them provide better quality of care for patients. One challenge of wiring doctors' offices is the high rate of failure once doctors purchase technology. This fear of failure suppresses demand for IT, Brailer said. Part of the problem is that there is no single entity that compares various IT products. He called on the industry to help create a "functioning market" for health information systems.

Interconnecting care: It's not just essential to use technology. It must be interoperable, Brailer said.

Personalizing care: People should have access to information and personalized treatment options while still maintaining privacy, according to Brailer.

Improving population health: This includes improving the accessibility of clinical trial data and developing biosurveillance systems.
Historically, IT has been relegated to second-tier status in health care, a position the industry should not accept, Brailer said. Better use of information technology in medicine will change the system."We're talking about nothing short of reforming health care," he said.


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