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Remarks by David Brailer, MD PhD
National Coordinator for Health Information Technology
HIMSS 2005


Introduction

Before I begin, let me just say how good it is to see the strong leadership and
overwhelming support in the industry. There are so many people and
organizations leading this effort that there should be little doubt that real change
is underway. If everyone in America came to HIMSS, they would see this
remarkable progress first-hand.

We all know that health information technology has deep roots going back 30
years, but President Bush started off this current phase a little more than a year
ago, and he hasnt stopped. He spoke about health information technology
nearly 50 times last year, and already has done so 3 times this year. The new
Secretary of Health and Human Services, Mike Leavitt, is making health
information technology a major priority for the Department. He is an articulate
and thoughtful leader who sees the power of information technology in
healthcare.

Many factors have converged to give lift to the health information technology
movement. Philanthropies such as California Health Care Foundation, Robert
Wood Johnson, the Markle Foundation, and many others have provided not just
funding, but leadership, expertise and passion. They are joined by two dozen
leaders of federal agencies who are aligning health IT across the government
in particular, Jonathan Perlin and Rob Kolodner from the Department of Veterans
Affairs, Bill Winkenwerder from the Department of Defense, Mark McClellan from
CMS, Carolyn Clancy and Scott Young from the Agency for Healthcare Research
and Quality (AHRQ), Elias Zerhouni from NIH, Andy Von Eschenbach from the
National Cancer Institutes, and many others.

In the private sector, we have seen strong leadership from medical informatics,
nursing informatics, and the medical and nursing professional societies all of
which see the promise of health IT. Scott Wallace and the Commission for
Systemic Interoperability are working in a complementary manner with our
efforts, and are on course to produce a report that will sharpen our focus on
critical issues. Mark Leavitt and the Certification Commission for Health IT are
working hard to get certification underway. So many other efforts have
accelerated this year that I cant catalogue them here, but you have witnessed
them at this meeting. I do have a special thanks to Steve Lieber, who invited me
to speak with you all today. Thank you all for your time, passion and leadership.

Today, I want to talk about where weve been and where we we as in all of us
who are charged with bringing about a new healthcare industry are going.

February 17, 2005

Page 1 Remarks by David Brailer, MD PhD
National Coordinator for Health Information Technology
HIMSS 2005


Context

Healthcare is a remarkable and unique industry. It is the only industry that gives
days to our lives. Think about it how many things can you buy or use that add
to your time on Earth? Or that increase someones pain-free, functional and
productive days? Everyone knows the U.S. is getting older longevity at birth
has increased from 73 years in 1975 to 77 years in 2000. Some say this is a bad
thing; that its a challenge to our economy. I say this is good; it adds quality to
our life and productivity to our economy. This is healthcare at its best.

Information technology plays a significant role in our progress. We know that
information technology supports treatment choices for consumers and enables
better and more cost-effective care. It does this by supporting and helping the
caregivers and professionals who make a real difference in the lives of
Americans. Health IT not only adds value to the way people lead their lives, but
it gets more out of our investment in healthcare overall. Health IT can help the
U.S. become more globally competitive that is, it can increase our productivity
and our standard of living at the same time.

We have not thought about health IT as a cost-effective form of therapy. Yet, the
best evidence is that when it is used as intended, heath IT saves lives and saves
money. A recent study showed that clinical information is frequently unavailable
in primary care, and that this missing information can be harmful to patients.
That study also showed that clinical information was less likely to be missing in
practices that had electronic health records. This adds to the substantial
evidence that health IT such as computer-physician order entry, ePrescribing,
preventative reminders, and bar code scanning to name a few improves care,
reduces wasteful and redundant treatments, and prevents medical errors. Little
doubt remains about the health status benefits of health IT.

Health IT will transform the way Americans regard their health and the way they
participate in healthcare. The important aspect of health IT is not software and
computers it is physicians making better treatment decisions, nurses and
pharmacists delivering safer care, and consumers making better choices among
treatment options. It is the way people connect together across a fragmented
delivery system from physician offices to hospitals to skilled nursing facilities
and even to the consumers home. It is putting consumers in control of their
health status, and customizing care delivery to meet their needs.

The past year

We have come a long way over the past year. Im not just talking about my office
the National Coordinator for Health Information Technology. Look around you,
and you will see who I mean when I say, We. Im talking about healthcare and
February 17, 2005

Page 2 Remarks by David Brailer, MD PhD
National Coordinator for Health Information Technology
HIMSS 2005


health IT leaders in particular. We have witnessed and participated in a
remarkable year by any measure. Here are just a few of the highlights:

Last year, President Bush highlighted health IT as an important priority for the
Administration. In the 2004 State of the Union Address, he said: By
computerizing health records, we can avoid dangerous medical mistakes, reduce
costs, and improve care. In his April 27th speech, he laid out the Executive
Order establishing the position of the National Coordinator for Health IT and
announced his goal for most Americans to have interoperable EHRs in 10 years.
As you know, we released the Framework for Strategic Action on July 21 it
presented four goals and 12 strategies for how we will achieve the Presidents
vision.

Im was pleased that the Presidents first trip of the second term was to the
Cleveland Clinic, where he talked to physicians and patients about the value of
health IT. As you know, Secretary Leavitt came as well he was on the job for
only 15 hours when he made the trip. In Cleveland, the President reinforced his
support for health IT by announcing that he was seeking an additional $50 million
in FY05 and $125 million in FY06 to support projects in the National
Coordinators office.

In the 2005 State of the Union Address, the President again highlighted his
commitment to health IT. The President placed health IT within an overall set of
healthcare initiatives that include tax credits to help low-income workers buy
insurance, community health centers in every poor county, expanded health
savings accounts, and medical liability reform to reduce healthcare costs and
improve access.



Over the past year, vendors have reported increased sales of EHRs, consultants
have reported increasing engagements for healthcare business transformation,
advocacy and research groups have produced dozens of reports on health IT,
and policy organizations have sponsored countless conferences. Physicians and
consumers have heightened their awareness of the value of health IT, and
payers and purchasers are stepping up their efforts to support this
transformation. This is a groundswell that is nation-wide, broadly supported and
growing.

We have indeed come a long way this year, but there is so much more to be
done if we are to realize the vision that the President and many of us have for a
better healthcare industry.
February 17, 2005