HHS Takes a Community Approach to Networking EHRs
To bring the advantages of modern technology - with greater safety, convenience, and economy - into the health care arena, President Bush has asked the federal government to develop a nationwide electronic health records (EHR) system within 10 years. But to maximize the benefit of EHRs, the system must enable information to reach all those who need it (and are authorized to use it) to improve health and health care - including patients themselves. To mobilize key stakeholders and address the technical and policy challenges from diverse perspectives, HHS Secretary Mike Leavitt recently organized an advisory group, the American Health Information Community.
The group met with Secretary Leavitt for the first time on October 7 for a comprehensive discussion, characterizing benefits that consumers could realize through EHRs in as little as 2 to 3 years.
The move to digitize health information is already well under way in the public and private sectors. Large hospitals have been developing EHRs to help manage patients between inpatient and outpatient settings. (See NCI Cancer Bulletin, June 21.) On the federal front, the Department of Defense has been using an EHR system since the early 1990s, and the Veterans Health Administration has been using one, known as VistA, since the 1980s. VistA was recently adapted by the Centers for Medicare & Medicaid Services for use among small physician practices.
But in light of the current push for nationwide EHRs, one of the challenges will be aligning existing systems with new technology, and vice versa. This process is being performed on multiple fronts, with leadership by Dr. David Brailer, national coordinator for Health Information Technology, and advisor to Secretary Leavitt in this capacity.
At NCI, relevant projects - including the cancer Biomedical Informatics Grid (caBIG) and SEER (Surveillance, Epidemiology, and End Results) program - are contributing to the national system by building an interoperable cancer information network, tools, and databases that make biomedical and clinical information available more quickly and easily than was previously possible. "Through caBIG, clinicians and researchers from around the country could ultimately use information that has been gathered from diverse sources across the nation, all to help determine the best approach for treating a specific cancer patient," explains Dr. Ken Buetow, who oversees caBIG as director of NCI's Center for Bioinformatics.
To ensure that NCI initiatives are closely aligned with HHS efforts, NCI staff play lead roles in key HHS groups, including the National Health Information Infrastructure Workgroup, the Federal Health Architecture, and the Consolidated Health Informatics Initiative. "Our goal with caBIG is to be sure that we're coordinating and collaborating with other federal activities, but also to enable them to learn lessons from us where it's helpful," says Dr. Buetow.
The Community will continue to meet with Secretary Leavitt every 4 to 6 weeks. Upcoming tasks include establishing workgroups to address biosurveillance, chronic disease monitoring, and consumer-driven electronic records, as well as continuing to discuss quality monitoring and reporting and e-prescribing technology.
In the meantime, the government is intensifying its push toward the 10-year goal through funding. On October 6, the Agency for Healthcare Research and Quality awarded 16 project planning grants totaling $22 million to prepare rural and underserved communities to adopt EHRs. HHS also awarded three contracts to public-private groups for $17.5 million to harmonize data standards, develop criteria for certifying compliance with those standards, and develop conformance solutions to patient privacy regulations.
In terms of the cancer-focused work being done through SEER and caBIG, Dr. Mark Clanton, NCI deputy director for Cancer Care Delivery Systems, says that a national EHR will dramatically improve the impact of these tools, as well as the quality of care and quality of life for cancer patients. "With access to a patient's full medical history, clinical trial investigators and health care providers will be able to make more informed decisions about the appropriateness of a trial for an individual patient and to adjust treatment to each patient's needs," he says.
By Brittany Moya del Pino