‘Czar' title doesn't seem to fit Brailer

By Jack Beaudoin
12:00 AM

DAVID BRAILER, the economist, physician and entrepreneur tapped to become the first national healthcare IT coordinator, is clearly uncomfortable with the term "czar."

Ever since former president Ronald Reagan made moralist William Bennett the nation's "drug czar" two decades ago, cross-agency coordinators appointed by the White House have had to carry this unfortunate title regardless of how apt it was.

Now I don't know Brailer personally. And I never met a real czar. But my introduction to Brailer at last month's TEPR show, and my passing acquaintance with Russian history, suggest that we in the media ought to be looking for a new title for the good doctor.

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Brailer's resumé reveals a man of action. One doesn't come by an M.D. and a Ph.D. without a little bit of initiative – or start up a successful healthcare IT company, or help set up a regional consortium to enable health data sharing among providers, for that matter – without the ability to get things done.But unlike the czars of the history books, Brailer does not appear to be the kind of leader who expects that the path to achievement rests in command. In his keynote address at TEPR, Brailer made it clear that he knows real change is only possible if those who are at the ground level are involved and invested in the transformation.

"We're in this together," he told attendees. "I certainly hope I can call on you all as a resource, as a trusted partner in this process."

Brailer is sincere. He really does want to make sure that everyone – from the solo practitioner to the CIO of major integrated delivery networks – has a chance to weigh in on what will become the national agenda for healthcare IT. We think it's a great strategy, which is why we launched our first reader poll asking Healthcare IT News subscribers to give Brailer advice on his priorities.

We were overwhelmed with responses, and tried to capture the gist of your messages in a story on page 4 of this issue. The letter below is just one example of the cogent, thoughtful insights that characterized the letters we received.

We also decided to post every response in its entirety on our Web site.

As for the "czar," he repeatedly described his current activities as a listening tour. He was at TEPR to solicit input, not to unveil a grand plan of action. He planned to do the same at the NAHIT annual meeting and at a number of other industry gatherings leading up to the July 20-23 conference on the National Healthcare Information Infrastructure effort, where the federal strategic plan will be released.

The danger in such a strategy is obvious – too many cooks stirring the soup and all that. But Brailer is well aware that every good discussion requires a conclusion, and while debate should be expansive, action must be focused. On interoperability and standards, for instance, Brailer declared, "We have to move beyond the dialog."

The words of a czar? Hardly. Given his academic background, maybe we in the media ought to call him the "Dean."

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