Brailer: "We have to move beyond dialog"
The nation's new healthcare IT czar said today he expects to release a detailed strategy to upgrade healthcare information technology by the end of July. At a press conference at " Towards an Electronic Patient Record" Conference in Fort Lauderdale, Florida, Dr. David Brailer said he's got just 71 days to produce a national strategy as called for by President George W. Bush.
Dr. David J. Brailer
"In April, the president ordered that all federal agencies that touch healthcare – either 14 or 15 in all, depending on how you count them – must come back with a strategic plan within 90 days," Brailer said. While the plan may not be minutely detailed given the time constraints, Brailer predicted it would "include important statements of principles about where we will go."
It's likely the strategy will be released at a National Healthcare Information Infrastructure conference in late July. If Brailer's talk at the TEPR conference is any indication, the plan will focus on implementing national interoperability standards and requiring IT vendors to certify their solutions are compliant. The plan is also likely to specify the need for financial incentives to drive provider uptake.
Technically, Brailer hasn't even started his new job. While Health and Human Services Secretary Tommy Thomson announced Brailer had been appointed to the post on May 6, Brailer's first day in the office comes next week. "I'm still trying to figure out how my email works," he quipped to industry journalists,
That doesn't mean Brailer has been sitting on his hands. He's been consulting for HHS and the White House on interoperability and other IT projects in Washington, D.C., for several months. Lately, he's been crisscrossing the United States to speak at conferences such as TEPR to begin outlining the goals of his office.
"I can stand in Washington and yammer all I want, but it's not going to do anything unless I can communicate with leaders in the industry," Brailer noted. "When the president talks about your sector, there's an expectation that you will get things done quickly."
Brailer refused to be drawn into specific actions he envisioned the federal government taking to drive information technology improvements in heathcare. Instead, he laid out his own views on the subject.
Foremost on Brailer's agenda is interoperability. "I'm an interoperability maven," he said. "Healthcare may be local, but it is also cross- organizational."
Brailer said that the government wouldn't build or endorse a universal system itself and force healthcare organizations and physician practices to adopt it. Unlike the project now taking place in Great Britain, the United States is likely to rely on the private sector to provide interoperable tools and for local, state and regional consortia to implement them.
What the government can do, Brailer said, is provide both carrots and sticks to urge providers to adopt IT tools that incorporate standards of interoperability. Among the incentives Brailer listed, financing and education were obvious tools, although he was looking for others as well.
HHS is looking at certifying applications for interoperability as well. Although he insisted the federal government wouldn't create the certification standards or serve as a certifying body, he said the creation of a certification body from within private industry was essential.
"How do you take a minimal data set, features and standards, and have a mechanism to judge and inform potential buyers if the application they're considering meets those standards?" Brailer asked. "That's one tool, but the federal government isn't going to do it."
Brailer said that getting quick results was imperative – "We have to move beyond the dialog over standards," he said at one point – but not at the cost of failure.
"I'll tell you honestly… I think we're living with the ‘sticks'. Not in the sticks, but the pain in the industry today is so high that I think a lot of what we're trying to do is a pain-avoidance strategy," he said. "We're poised for a potential devolution in healthcare if things don't change."