Last week U.S. Health and Human Services Secretary Tommy Thompson released the first outline of a 10-year plan to build a National Electronic Health Information Infrastructure in the United States.

The report, “The Decade of Health Information Technology: Delivering Consumer-centric and Information-Rich Health Care,” lays out the broad steps needed to achieve always-current, always-available electronic health records (EHR) for Americans. This responds to the call by President Bush this year to achieve Electronic Health Records (EHRs) for most Americans within a decade.

See also: Conference Materials for National Healthcare Information Infrastructure 2004, last week’s summit on the subject.

Secretary Thompson announced a range of actions underway or soon to be launched, which will advance the strategic elements of the Framework:

Establishing a Health Information Technology Leadership Panel to evaluate the urgency of investments and recommend immediate actions — Secretary Thompson will appoint the panel of executives and leaders to assess the costs and benefits of health information technology to industry and society, and develop options for immediate steps by both the public and private sector, based on their individual business experience. The Health Information Technology Leadership Panel will deliver a report on these options to the Secretary no later than fall 2004.

Private sector certification of health information technology
— EHRs and even specific components such as decision
support software are unique among clinical tools in that they do
not need to meet minimal standards to be used to deliver
care. To increase uptake of EHRs and reduce the risk of
product implementation failure, the federal government is exploring
ways to work with the private sector to develop minimal product
standards for EHR functionality, interoperability, and
security. A private sector ambulatory EHR certification task
force is determining the feasibility of certification of EHR
products based on functionality, security, and

Funding community health information exchange demonstrations
— HHS’ Health Resources and Services Administration, with
the Foundation for eHealth Initiative, announced $2.3 million in
contracts to support the Connecting Communities for Better Health
Program. The program is providing seed funds to implement
health information exchanges, including the formation of regional
health information organizations.

Planning the formation of a private interoperability
— To begin the process of movement toward a
national health information network, HHS will issue a Request for
Information (RFI) this summer inviting responses describing the
requirements for private sector consortia that would form to plan,
develop, and operate a health information network. The role
that HHS could play in facilitating the work of the consortium and
assisting in identifying the services that the consortium would
provide will be explored, including the standards to which the
health information network would adhere in order to ensure that
public policy goals are executed and that rapid adoption of
interoperable EHRs is advanced.

Requiring standards to facilitate electronic prescribing
CMS is accelerating publication of a regulation laying out the
first set of widely adopted e-prescribing standards in preparation
for the implementation of the new Medicare drug benefit in 2006.
When the final standards are adopted, Medicare Prescription Drug
Plan (PDP) Sponsors will be required to offer e-prescribing, which
will significantly drive adoption across the United States.
The proposed regulation will be published by CMS this year.

Establishing a Medicare beneficiary portal — CMS will
develop a Medicare Beneficiary Portal, an immediate step in
improving consumer access to personal and customized health
information, providing secure health information via the
Internet. The portal will enable authorized beneficiaries to
have access to their Medicare information online or by calling
1-800-MEDICARE. Initially the portal will provide access to
fee-for-service claims information, which includes claims type,
dates of service, and procedures. The pilot test for the
portal will be conducted in Indiana, beginning this year. In
the near term, CMS plans to expand the portal to include prevention
information in the form of reminders to beneficiaries to schedule
their Medicare-covered preventive health care services. CMS
also plans to work toward providing additional electronic health
information tools to beneficiaries for their use in improving their

Commitment to standards — A key component of progress in
interoperable health information is the development of
interoperability standards and policies. HHS, DoD, and VA
have endorsed 20 sets of standards to make it easier for
information to be shared across agencies and to serve as a model
for the private sector. Additionally, the Public Health Information
Network (PHIN) and the National Electronic Disease Surveillance
System (NEDSS), under the leadership of the Centers for Disease
Control and Prevention (CDC), have made progress in development of
shared data models, data standards, and controlled vocabularies for
electronic laboratory reporting and health information
exchange. With HHS support, Health Level 7 (HL7) has also
created a functional model and standards for the EHR.

This announcement of a National Healthcare Information Infrastructure brings back memories of the push a decade ago for a National Information Infrastructure (which led to vast investments in building up the public Internet).