Healthcare IT News asked CIOs and physicians how they would like to see the new administration, particularly Health and Human Services Secretary nominee and director of White House Office of Health Reform Tom Daschle, proceed on the healthcare information technology front. What role should government play? What they had to say follows:

Denni McColm, CIO, Citizens Memorial Healthcare, Bolivar, Mo.
"I'd like to see the government encourage adoption of health IT through incentives for use, particularly the use of electronic medical records that eliminate the use of paper charts. Also, administrative simplification that isn't just simpler for the federal government from the payer side, but also allows hospitals and healthcare providers to be more efficient using EMR systems."

Joseph Kvedar, MD, founder and director, Center for Connected Health, Boston
"The role of government should be to set policy that will move the system from one that rewards transactions, or units of service, to one that rewards quality.  Incremental efforts like P4P on top of traditional fee for service are not making enough of a difference. CMS should implement a ferent payment scheme for chronic illness.  Systems are tools that are used to meet business needs.  To try to solve the problem by pushing systems, without changing the business rules would probably result in a waste. In the context of true payment reform, tax credits for implementing certain technologies would be a good idea, such as tools that enable EMR connectivity and tools that encourage patient behavior change and accountability for their illness.

Denni McColm, CIO, Citizens Memorial Healthcare, Bolivar, Mo.
I'd like to see the government encourage adoption of health IT through incentives for use, particularly the use of electronic medical records that eliminate the use of paper charts. Also, administrative simplification that isn't just simpler for the federal government from the payer side, but also allows hospitals and health care providers to be more efficient using EMR systems.

William Spooner, senior vice president, CIO, Sharp HealthCare
Many are eager for President-elect Obama to proceed rapidly in support of health IT, and amounts as large as $50 billion a year in HIT investment have been suggested.    These past few years we have discussed many required enablers for health information exchange strong leadership in the form of a permanent National Coordinator, aggressive adoption of interoperability standards, reconciliation and rationalization of conflicting privacy regulations, a patient identifier, etc.  Mr. Daschle should move boldly on these fronts.   
 As to massive spending, my best advice to Secretary Daschle would be to proceed cautiously.  Obtain broad input as to the I.T. investments likely to contribute most to healthcare quality and cost reform.  Resist the notion that the feds should broadly subsidize computer systems.  Seek to identify measurable criteria to reward providers who demonstrate improved outcomes in access, quality and cost.  Identify mechanisms providing equity for those providers who already invested in EHRs at their own cost.  


Jane Olds, chief operating officer, Louisiana Health Network, New Orleans
Government should push for an individual, national health ID # for all Americans that will enable easier exchange of data across disparate systems.  It is a major glitch that comes up in discussions of community connectivity that has put major partnerships in data exchange on hold.
I think the Federal Government has to continue to require IT adoption at all healthcare levels with tax breaks / incentives for smaller entities.   This is the only way we will move the adoption ahead at a faster rate. 
Heighten focus on transparency of published quality and outcomes reporting which will push patients toward a value driven, consumerism approach to personal healthcare choices.   Subsequent successes should be realized with significant cost savings from systemic waste and service duplication reductions.

Paul Tang, MD, vice president, CMIO, Palo Alto Medical Foundation, Palo Alto, Calif.
"I think the administration is absolutely focusing on the right things - providing universal coverage and reforming the payment system to align incentives for health and wellness.  Adoption of interoperable health IT (electronic health records and personal health records) is not only an enabler of those top priorities, it's a requirement.  I think the idea of a politically independent health board patterned after the Federal Reserve to set health policies may be the right approach."

Steven Waldren, MD, director, Center for Health-IT
American Academy of Family Physicians
Government should push for an individual, national health ID # for all Americans that will enable easier exchange of data across disparate systems.  It is a major glitch that comes up in discussions of community connectivity that has put major partnerships in data exchange on hold.
I think the Federal Government has to continue to require IT adoption at all healthcare levels with tax breaks / incentives for smaller entities.   This is the only way we will move the adoption ahead at a faster rate. 
Heighten focus on transparency of published quality and outcomes reporting which will push patients toward a value driven, consumerism approach to personal healthcare choices.   Subsequent successes should be realized with significant cost savings from systemic waste and service duplication reductions.