Experts push for health IT power

Consolidated Health Informatics initiative

Congress should make sure the new health information technology coordinator position has the power to implement IT standards, experts told a House subcommittee this week.

"As health IT initiatives are pursued, it will be essential to have continued leadership, clear direction, measurable goals and mechanisms to monitor progress," said David Powner, director of IT issues at the Government Accountability Office.

As part of the Consolidated Health Informatics (CHI) e-government initiative, all of the federal agencies involved in providing health care are working with the private sector to develop vocabulary and messaging standards for exchanging health information within the federal environment. One goal is that the entire public health sector will adopt the standards. The federal government represents more than a third of health care spending, said Karen Evans, administrator for the Office of Management and Budget's Office of E-Government and Information Technology.

She testified July 14 with several other officials before the House Government Reform Committee's Technology, Information Policy, Intergovernmental Relations and the Census Subcommittee.

President Bush created the position of national health IT coordinator by an executive order in April. Dr. David Brailer will be the one releasing the health IT strategy.

Newt Gingrich, former House speaker and founder of the Center for Health Transformation, told subcommittee chairman Rep. Adam Putnam (R-Fla.) and other members that Brailer's position should be permanent and include budget power. "Creating the office without the power doesn't get the job done," Gingrich said.

Gingrich also proposed several other measures to bring health care technology into the 21st century.

The Department of Health and Human Services, which is leading the CHI initiative, issued the first 20 standards in March 2003 and May 2004. Those standards will be applied as agencies and hospitals develop new health systems. They will also be used to modify existing systems for greater interoperability.

Even this early into the process, officials are finding that "the wonder of standards is that implementation is where the rubber really hits the road," said Claire Broome, senior advisor to the director for integrated health information systems at the Centers for Disease Control and Prevention. "I think we're learning a lot about what is involved in making these standards work so we can make the systems work together," she said.

One challenge so far has been the need to build up the IT capacity of the hospitals and health centers for the standards to be necessary, much less useful, she said. "You're trying to build infrastructure capacity at the same time as you're trying to build