When Obama takes office in January, the economy will be his first
priority, followed by the war in Iraq. Health care will follow as his
next major issue to address.
What will he do?
he’ll take a phased approach to ensuring all Americans have access to
health care. Given the change management needed to accomplish this, it
will take a while.
However, Health care Information Technology
has broad bipartisan support and is his best strategy to reduce
health care costs, reimburse providers for quality instead of quantity,
and to ensure coordination of care. Here are my predictions for
health care IT in the first year of the Obama administration:
AHIC Successor, with its board of 15 savvy operational people and three
incorporators (John Tooker, John Glaser and Jonathan Perlin) will serve
as the public/private collaboration for prioritization of health care IT
initiatives during the first year of the Obama administration and
The Office of the National Coordinator (Rob Kolodner) will continue to coordinate Federal input into the public-private effort.
The Health Information Technology Standards Panel (HITSP) will continue to harmonize standards. Its work in 2009 will include
new use case to harmonize the electronic standards needed to exchange
data about newborn screening for treatable genetic, endocrinologic,
metabolic and hematologic diseases.
Closing gaps in standards for
General Laboratory Orders
Advanced Device Interfacing
Secure Data Transport for all clinical data
Consumer Preferences for care
Long Term Care Assessments
Prior Authorization for testing
Consumer Adverse Event Reporting
HITSP has the AHIC Successor’s endorsement to work on standards for
Clinical Trials and Research in collaboration with CDISC and other
The Health Information Security and Privacy Collaboration (HISPC) working groups will continue to inventory and harmonize privacy standards for states and territories
the Obama team will offer incentives to implement EHRs early in the
administration, but in the meantime hospitals will subsidize 85% of EHR
implementation costs via Stark safe harbors and private payers will
offer pay for performance incentives for the outcomes resulting from
the use of EHRs and e-Prescribing.
States such as New York,
Massachusetts, Tennessee, Indiana and Utah will continue to implement
regional data exchanges that meet the needs of their local stakeholders.
The Certification Commission for Healthcare Information Technology
will continue to develop functional criteria for EHRs, PHRs and Health
Information Exchanges. HITSP harmonized standards will be included in
CCHIT criteria and incorporated into EHRs in an incremental way over
the next few years.
Thus ONC, the AHIC Successor, CCHIT, HITSP
and HISPC will continue their work for the next year. My personal
leadership role of HITSP continues until October 2009, crossing between
After the year it takes to stand up a new administration, we may see additional resources for health care IT, a new federally regulated exchange
where Americans not covered at work would be able to choose among a
variety of private group policies and a new public program to compete
with the private insurers. New public and private IT initiatives will
be needed to support the workflow of these new programs.
week, I’ll be in Washington for AMIA, the last meeting of the AHIC, and
an FDA meeting. I’ll report on how the transition teams are beginning
their work and the implication for health care IT.
John D. Halamka, MD, MS, is CIO of the
CareGroup Health System, CIOand Dean for
Technology at Harvard Medical School, Chairman of the New England
Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE, Chair of the US
Healthcare Information Technology Standards Panel (HITSP), and a
practicing emergency physician. He blogs regularly at Life as a Healthcare CEO, where this post first appeared.