Dr. David Brailer, who resigned April 19 as national coordinator of health IT, told reporters that the next coordinators job will not be to establish a vision but to keep a process moving forward.
Brailer, who is chairing the search for his successor, said a replacement will likely not be in place until the end of the summer. Though several candidates are being considered, he said, the search is still open.
Brailer said that being a Washington outsider had kept him from moving as quickly as he might have liked, but he said stable progress toward health IT is more important than speed. “I knew that my ability to influence Washington was to create a groundswell,” Brailer said, referring to his grueling speaking and travel schedule.
He said the groundswell happened and wont be reversed: “The inertia that makes it hard to get anything under way in Washington is now working for us.”
While Brailer said his successor must be able to navigate the Washington machine, he doesnt anticipate that the next coordinator will come from within government. “Some academic experts could do well if they could manifest the pragmatism,” he said.
“Mike Leavitt has been so much on his game that it really decompresses the role,” Brailer said, adding that he and the Department of Health and Human Services secretary share such a similar philosophy about how to shape health IT that a substantial shift in policy is unlikely.
Brailers resignation has sparked rumors that he was urged out as part of a White House shake-up and that he was unhappy with the direction that the administration was taking on health IT or that Leavitt was taking an increasingly active role directing health IT.
But Brailer said he had never planned to stay in the national coordinator role for more than two years and that his Beltway job kept him from his family and young son in San Francisco five nights a week.
Brailer did have some oblique criticisms as he gets ready to leave his post. Even though government agencies as disparate as the Internal Revenue Service and the Department of Agriculture can have a great impact on health care, Brailer said he found “overall IQ about health care to be really very low.” And nontechnology barriers are a big hindrance. “Health IT is best pushed forward in the presence of a comprehensive health policy,” he said.
Brailer will be keeping a smaller government role. He will serve as vice chairman of the American Health Information Community, which was established in June 2005 to foster adoption of health IT. The 17-member panel represents large employers, technology companies and high-ranking officials from Medicare and the Department of Veterans Affairs. Executives from Intel, Cisco Systems and Verizon are on the committee.
Brailer said hed been “amazed” at thousands of messages of support hed received since his resignation was announced and asked reporters to convey his thanks.
Brailer estimated it might take until the end of the year for his hectic travel schedule to wind down and said he hasnt “seriously considered” what he will do next.
However, the medical doctor and trained economist said he plans to push forward a transparency initiative that will make patients more involved in maintaining their health. “Economically, weve just begun to understand how consumer forces work in health care,” he said, referring to patients as consumers.