By Brian Robinson
After nearly 30 years spent guiding and implementing health technology projects, Harry Reynolds sees health IT issues more as journeys that have to be navigated and experienced rather than dealt with as discrete problems.
The new chairman of the National Committee on Vital and Health Statistics sees the Health Insurance Portability and Accountability Act (HIPAA), first passed in 1996, as charting new ground, for example. Before it was about specific transaction, but now he feels it's about how it can be used more broadly for better outcomes for the public health.
HIPAA is the subject that's most often associated with the committee, even as it approaches its 60-year anniversary. But Reynolds thinks that, with issues such as personal health records and the National Health Information Network to be dealt with, the committee is entering new and even more complex terrain.
"In the past each of the subjects the committee has dealt with have been less integrated and dealt with separately, but now it's impossible to separate them," he said. "Now we need to look at things holistically, and understand the breadth of their involvement and influence on each other."
The committee advises the Health and Human Services Department on health IT, standards and related matters. Reynolds, a vice president of Blue Cross and Blue Shield of North Carolina, took over the chairmanship from Dr. Simon Cohn, associate executive director of Kaiser Permanente's Permanente Foundation, when his term expired on June 1.
Though he's been a long time in the business, Reynolds can still be moved by health IT developments, such as e-prescribing.
"I'm as excited by that as I have been about anything in my entire career," he said. 'It's really one of those things that can raise the water level for everyone, can actually save lives and reduce errors, and I think it can become the model for many other things."
It's almost to the point where there's now a cookbook approach to implementing e-prescribing, he said, "and that's cool, but a significant part of the challenge is getting doctors to take it up and integrate it into their workflow. So how do we build something through standards and other approaches that will allow everyone to be brought into this."
Even HIPAA, which he's dealt with as a committee member and in his day job since it was passed, holds intriguing possibilities for the journey ahead.
There's been tremendous changes in health IT since the act was passed, Reynolds said, and it was never really designed to deal with the current situation. Just five years ago, technology was still considered an impediment to getting things done, he said, but that's not the case now when it's easy enough to use and can be installed in just about any situation.
On the other hand, since patient and personal information can now be found anywhere in the system, privacy and security have become overarching concerns in the adoption of health IT. Some people believe that requires a whole new law, beyond HIPAA.
Reynolds isn't one of them. For a start, he says, there would be many more problems today if HIPAA never existed. However, his own view is that there will probably need to be some major changes to HIPAA if it is to deal effectively with the societal concerns of how that information is used.
"Perhaps anyone who handles health data should be considered a covered entity under the law," he said. "Once you do that, there's plenty of protections you can put in place."
For Reynolds, it's now also more of a personal journey as well as a professional one. He's having to see his parents deal with the aging process, and he's just become a grandfather. And he's thinking more often about the kind of health care he can find in the various places he visits on his still extensive travels.
What motivates him is that health IT potentially affects everyone. "Every time you talk to people about sick parents or about chronic health situations, and you know you have the opportunity to affect the lives of so many," he said. "That's what gets you really excited."