Massive collaboration needed for health care IT interoperability

The federal and state governments and industry will have to collaborate to achieve a health care system made up of local and regional interoperable networks, Health and Human Services secretary Michael Leavitt said today.

HHS will first request that states determine the privacy and security problems they face related to digitizing health care information and what could impede interoperability. For example, privacy and security regulations under the Health Insurance Portability and Accountability Act provide baseline safeguards, but a number of states have more stringent requirements. Variations in privacy and security standards can impede interoperability, Leavitt said.

HHS will release details soon how the federal government will promote collaboration, including helping set up and fund standards organizations outside of government.

"It's time for us to make a forced march commitment," he said at the National Association of State CIOs' mid-year conference in Washington, D.C.

Regional health networks will depend on standards and an open architecture to be interoperable. The problem is that many standards already exist. Large hospitals and physician practices are increasingly using IT in health care. "But it's a massive number of systems that can't interact with each other," Leavitt said

Government pays for 46 percent of U.S. health care costs now, and as such can influence and encourage standards for interoperable networks.

Federal and state government can bring private and public participants together to collaborate and develop standards and encourage industry to agree on standards. Government can also be an early adopter of health care IT. "And after a time in the future, after everyone has had a chance to know about this, we're going to insist that those who do business with us adopt those standards," Leavitt said HHS.

HHS has requested $125 million in the fiscal 2006 budget to coordinate and support health IT programs across government through the office of David Brailer, the National Coordinator for Health IT, which is working with agencies involved in delivering health care, such as DOD, VA and the Indian Health Service.

There's an economic imperative to adopt health IT for its potential cost savings, Leavitt said. Health care costs $5,700 per person annually now compared with $143 in 1960. Health care costs consume $1.7 trillion annually and accounts for nearly 16 percent of the total economy.

Leavitt yesterday released a 500-day plan for department priorities, including advancing health IT. Among them were:

Convening a national collaboration to further develop, set and certify health information technology standards and outcomes for interoperability, privacy and data exchange.

Realizing the near-term benefits of health IT in the areas of adverse drug-incident reporting, e-prescribing, lab and claims-sharing data, clinic registrations and insurance forms.