"Interoperability must be addressed now, or else widespread adoption of stand-alone EHRs will be a fait accomplis," he said in remarks at the annual meeting of HIMSS (Healthcare Information Management and Systems Society), held this month in Dallas.
Stand-alone EHRs would mean companies would keep their information as a proprietary, strategic asset. This would limit EHRs ability to provide consumer choice and improve public health. This situation must be prevented from happening, Brailer said, not fixed after the fact. "We cant wait until the end to make the tough decisions to get the results we all want – we need to attack the core issues and barriers right now."
However, Brailer made it clear that he wanted the industry to assume leadership in this area, and he has frequently said that government regulation does not provide the flexibility the government needs to innovate.
While praising Brailers efforts, the general manager of IBM Healthcare, Carol Kovac, has said that the government needs to provide muscle for standards.
In interviews with eWEEK.com prior to Brailers speech, two leaders of health IT groups said that ONCHIT (Office of the National Coordinator for Health Information Technology) should lay out an overall plan for an interoperable network and allow industry to fill in the details. Don Mon, vice president of industry at AHIMA (American Health Information Management Association) said that the federal government should help develop a common framework and test its implementation. Then, he said, market forces could come into play.
Robert Seliger, head of the HIMSS interoperability workgroup and CEO of Sentillion Inc., said that the national health information network could work on a franchise model. "If ONCHIT can define the corporate agenda, [the office and health IT groups] can blueprint it, and maintain a uniform level of service even though they [health information systems] are independently managed."
In his speech, Brailer hinted that such a blueprint should be a framework. Last month, Brailers office received over 5,000 pages in over 500 responses to his request for feedback on a national health information network. Brailer said that an interagency task force was reviewing the submissions and would release a public summary and analysis in a few weeks. The office will publish a strategic plan covering EHR adoption, interoperability and other issues this year.
Brailer described several emerging themes based on the 500 responses. The top three are included below.
Standards. Interoperability standards and policies for the NHIN require immediate attention from the federal government as well as public- and private-sector participants.
Governance. There is a need for governance of the NHIN that protects the publics interest, particularly the interplay between the public and private sectors.
Privacy. Privacy concerns were in the forefront of nearly all responses, focused on how the NHIN should ensure that patients have control over who has access to their data.
The text of Brailers speech is available here as a pdf.