Health IT leaders set an aggressive schedule

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Health IT

Pilots for e-health records, e-prescribing part of year-end plan

Several small-scale tests of health IT over the next year should go a long way toward showing physicians and consumers the possibilities of fusing technology and health care.

The public-private American Health Information Community'led by Health and Human Services Department secretary Michael Leavitt'is fleshing out plans for the first version of personal health records and other health IT initiatives on an aggressive schedule. Pilots are expected by Dec. 31.

The first versions will test small components using existing technologies that will later become part of comprehensive systems.

'They may seem like narrow pieces, but they will move the whole forward in a big way,' Leavitt said.

Leavitt expects the personal health record pilot to fuel consumer support for health IT because it will let consumers for the first time access and manage their health information.

In his State of the Union speech last week, President Bush reiterated his support for electronic health records and other health IT 'to help control costs and reduce dangerous medical errors.' On its Web site, the White House lists projects for this year, including the 'medical clipboard,' medication history, lab results and disease monitoring tools.

The pilots will help generate the kind of excitement that gets things done, said Wes Rishel, managing vice president of the health provider practice at Gartner Inc. of Stamford, Conn.

A potential pothole is that people may focus narrowly on one use and lose any collaborative effect, he added.

'Here they're doing a good job of using those breakthroughs as legs to hold up the whole table,' he said.

AHIC has developed a road map for its early versions of a personal health record, bioterrorism response, electronic health record and online tools to help streamline chronic care by December. AHIC workgroups are made up of representatives from federal and state government, health care providers and payers, and the IT industry.

AHIC also will incorporate work by vendors and groups that HHS has contracted to develop and test electronic prescribing, interoperability standards, product certification and prototypes for a nationwide health information architecture.

For example, pilots to share lab results will have to meet some of the interoperability standards and product certification.

Millions of consumers will want to use an electronic registration summary, the first component of a personal health record, when it is deployed, Leavitt said. Electronic registration will replace the so-called medical clipboard and relieve patients of having to fill out duplicate information forms at each medical visit.

'It will ultimately drive the market in a viral way, since insurance plans are interested and are already doing some similar initiatives,' Leavitt said.

The plan is for an expansive, accessible record that includes technologies allowing for record registration, medication history and past medical history, he said.

'I plan to use my authority as secretary of HHS to use government-paid health services to drive this,' Leavitt said.

Employer insurance plans and large, managed-care providers are a likely source of support for a personal health record.

Indiana will start using personal health records for 600,000 Medicaid beneficiaries in January 2007, said Mitch Roob, secretary of the Indiana Family and Social Services Administration and an AHIC member.

E-prescriptions

HHS already has substantial work under way on e-prescribing, said Kelly Cronin, director of the Office of Programs and Coordination in the Office of the National Coordi- nator for Health IT.

The department recently a-warded four contracts to test e-prescribing standards in seven states' health care markets this year. The pilot will focus on how medications are prescribed, workflow changes as a result of electronic transactions, and the extent to which they reduce errors, time and cost.

This year, the four groups working on the prototypes for a nationwide health information architecture will tease out common architectural elements, such as standards harmonization and certification, said John Loonsk, director of the Office of Interoperability and Standards in the national coordinator's office.

'We intend to bring together the best architectural performance from these four consortia and take the shared architectural aspects and implement them in operational activities,' Loonsk said.

The capacity to share data is going to be a national asset, said David Brailer, national coordinator for health IT.

About the Author

Mary Mosquera is a reporter for Federal Computer Week.

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