HHS Report on Health IT Accomplishments

An assemblage of governors, state officials, federal bureaucrats and health care experts gathered in Washington, D.C., Jan. 26 for the inaugural meeting of the State Alliance for e-Health, an initiative of the National Governors Association's Center for Best Practices. The alliance's charge is to advance the widespread adoption of health information technology and interoperable health information exchange.

Jim Douglas, governor of Vermont and co-chairman of the group, said the ultimate goal is to provide health care information to consumers and providers "any place, any time. There are real challenges, that's why we're all here."

Involving states in the effort to create a system of shared electronic health information "is exactly the right way to go about it," said Phil Bredesen, governor of Tennessee and the alliance's other co-chairman. If the e-health initiative is to overcome the thorniest issues impeding widespread adoption, such as privacy and consumer protection, "states have to be a partner."

The governors' opening remarks underscored the difficulty of their task. The Bush administration has challenged the health care sector to adopt electronic health records by 2014, but implementation of that goal is far off, said David Powner, director of IT management issues at the Government Accountability Office, testifying before Congress in the fall.

Taking a more sanguine view, the Department of Health and Human Services has released a report enumerating major accomplishments of its health IT initiative.

Robert Kolodner, interim national coordinator of health information technology at HHS, said widespread adoption of electronic health records would transform the country's health care sector into "a real nationwide health care system."

Jim Geringer, a former governor of Wyoming, was quick to note, however, that the states were not interested in a national database of health care information managed by the federal government. "It's not going to be a single, uniform system," he said.

Kolodner suggested that the intent of the initiative is to create a network of vendors that would achieve the goal of interoperable EHRs while providing choices to consumers. Under one possible model, people would entrust stewardship, management and release of health information to third-party organizations, much the same way that consumers entrust financial assets to banks. And just as the country has a seamless telecommunications system supported by competing telephone companies, a system of EHRs built on disparate providers could provide for the reliable exchange of health information, Kolodner said.

Integral to the success of the enterprise is the adoption of common standards required to surmount data, technical and security obstacles.

"Without those, we have the tower of Babel," Kolodner said. "We need to get those standards in place."

To that end, Mike Leavitt, HHS' secretary, announced last week his acceptance of 30 standards recommended by the Healthcare Information Technology Standards Panel.

The alliance, created in October 2006 under a contract with HHS' Office of the National Coordinator for Health IT, aims "to improve the nation's health care system through the formation of a collaborative body that enables states to increase the efficiency and effectiveness of the health information technology initiatives they develop."

In coming weeks, the alliance will begin staffing three task forces charged with investigating the implications of EHRs with regards to protecting health information, health care practices, and health information and communication.