Editor's Letter: A community in flux

A lot can change in a year. Up until last year, Federal Computer Week covered the health care arena sporadically, focusing primarily on the Defense Department's Composite Health Care System. The modernization of the health care industry, though fascinating from a personal perspective, did not appear to be a federal issue.

Still, we paid attention when, in April 2004, President Bush outlined a plan to have electronic health records for most Americans within 10 years and when, a week later, Department of Health and Human Services Secretary Tommy Thompson introduced Dr. David Brailer as the first coordinator of national health information technology.

Some people initially were skeptical that the federal government could or would play a major role in driving the use of health IT. The feds just seemed too far removed from the action, despite the significant money the government spends through the Medicare program.

But the Bush administration and Congress are proving otherwise. In the past year, we have seen a flood of new ideas, policies and legislation streaming out of Washington, D.C. Some of it probably will not pan out, but all of it points to a larger role for the federal government in this ongoing transformation of the health care sector.

HHS is driving the development of technology standards, Congress is funding grants to spur the adoption of electronic health records and related technology, and the Defense Department, among others, is blazing the trail, showing how those standards and technology can significantly improve health care and health care management.

It's still too early to gauge the success of these efforts, but it is already clear that the federal government is changing the dynamics of this field, convincing people not to think only in terms of modernizing health care, but transforming it.

Another thing we have realized in the past year is that the U.S. government is not alone in those efforts. Governments worldwide are wrestling with the same issues, and despite demographic and cultural differences, much might be learned from studying their efforts. Likewise, as is often the case with government programs, the individual U.S. states, cities and counties are working on the front lines, crafting and implementing policies and programs.

The following special report tries to capture those dynamics, highlighting some landmark efforts to deploy technology in the field and explaining how governments here and abroad are helping bring this transformation about.

— John S. Monroe, Editor in Chief