Dr. Blumenthal: NHIN architecture a 'work in progress'

Dr. David Blumenthal, the national coordinator for health information technology at the Health and Human Services Department, has a monumental mandate: It's he and his office who are most prominently leading the charge to put a national health network in place. He recently spoke to Federal Computer Week reporter Alice Lipowicz about his work and its future.

FCW: As you move forward on health IT certification and meaningful use under the economic stimulus law, to what degree does the success of health care reform depend on the successful utilization and broad adoption of health IT?

Blumenthal: I think of health IT as part of the health reform agenda, an integral part, and whether we do it this year or sometime later, health IT will be there to make it more effective.

The better we do with the health IT agenda the better we will do with efficiency and quality of care. To realize the president’s vision of an efficient, much improved and higher-value health system, an effective health IT system is vital. The legislation doesn’t expect that to happen overnight. It suggests a time frame of 5 to 10 years, and in fact, this is a never-ending journey of information management in the modern age.

FCW: What role does the NHIN have in your vision for health IT? Will you retain the current architecture or change it?

Blumenthal: The NHIN is a vision of an interconnecting health system where information flows freely and securely. We view it as a major responsibility to develop both information exchange, and privacy and security protection. I don’t see this as a choice between an NHIN that is secure, and something else. Whatever we do, we have to meet criters for privacy and security that meet the needs of the American people.

The architecture is a work in progress; it is a demonstration program. To say it is finished is premature. We are working on creating a private, creative, secure and interoperable capability for health information exchange for federal participants and private participants as well. We won’t finish and spin it off unless it is secure and private.

We are charged to look at existing programs and reconsider them in light of the (economic stimulus) law. We will get advice on the federal role in NHIN and when we can say that it is ready for prime time. But at the current time it is still a demonstration program and is not a functioning system. It has shown that it is capable of exchanging information. I think personally it is a very important part and we are working actively on it. It will serve a lot of purposes, including being a major asset for federal providers who want to connect their systems.

FCW: What is your stance on innovation and use of open-source health IT?

Blumenthal: We want to create systems that are open to innovations and compatible to technological change and changes in customs. That is our aspiration. As for a commitment to open source IT, we don’t have preferences.

FCW: How do you picture the federal agencies applying health IT?

Blumenthal: I think federal agencies will be trendsetters, just like the Veterans Affairs department was a trendsetter n the use of Electronic Health Records. I think they will be trendsetters in exchanging information, and optimistic about the VA/DOD demonstration to make exchange easy and effective. The Social Security Administration has also been very innovative.

FCW: Should health data be collected and controlled by patients in Personal Health Record banks?

Blumenthal: We absolutely do not want to stand in the way of, or inhibit, Personal Health Records, if the public decides they would rather store information in their own health accounts, and allow access to it, rather than have providers store that information, and we can make that part of a functioning health system.