Dr. David “Hercules” Brailer, MD, the National Health Information Technology Coordinator, wowed a standing room only crowd with a breathtaking pace of nonstop political and technical star speakers at the opening day of the 2004 NHII Conference. Featured speakers included HHS Secretary Tommy Thompson, U.S. Senate Majority Leader Bill Frist, Cisco CEO John Chambers, and former Speaker of the House of Representatives Newt Gingrich. It was an NHII love fest, with successive speakers praising Dr. Brailer ever more effusively. Overflow crowds watched the proceedings on large video monitors in a big room across the hall from the packed main gallery.
The day was heavily scripted with presenters from every facet of the health care enterprise. Dr. Brailer and Sec. Thompson started the day with a Press Conference to announce the release of the new “Framework for Strategic Action” for using technology to transform health care in the United States. After the press conference, Sec. Thompson delivered an opening address to the crowded main hall. He described the NHII as the start of a decade of change in health care to transform the practice of medicine. He then rushed over to the White House to attend a Rose Garden signing ceremony for the Project Bioshield Act of 2004.
While open source software was not prominently featured in the NHII presentations, open standards and public domain efforts were core concepts. The many references to VistA from the podium obliquely referred to open source. Meanwhile, leaders from World Vista project circulated in the crowded main hallway of the convention center wearing prominent buttons reading, “Ask Me About OpenVista.”.
Dr. Brailer stressed his new framework for strategic action in health care informatics. The framework has four categorical tracks, with three specific tasks in each track. The entire document is available here.
Major themes Dr. Brailer mentioned were standards for interoperability, funding incentives, technology development and accumulating metrics to measure the impact of technology on health care decision support systems.
In addition to Sec. Thompson and Dr. Brailer, eleven Federal Department and Agency Heads spoke, each explaining how the NHII is shaping their technology agenda. The leaders represented CMS, NIH, CDC, AHRQ, FDA, HRSA, IHS, DOD, and the VA. In a humorous vein, each speaker during the day raised the stakes in praising the efforts of Dr. Brailer, and by mid afternoon the consensus was that he is like Hercules.
In an animated presentation, Sen. Frist, an MD and a Heart Surgeon, said he hopes this NHII conference represents a tipping point for a national agenda for technology in health care. He observed that health care costs are growing four times faster than wages for Americans, and that modern developments in health care technology will allow us to reintegrate our health care system to deliver accurate, timely and readily available clinical information. He called EHRs the cornerstone of our new modern health care system, and he observed that Dr. Brailer’s efforts with the NHII will be a transformative effort to deliver systemic change. Sen. Frist described the NHII as a means to make health care information seamlessly available to patients and clinicians from any Internet portal.
John Chambers, CEO of Cicso, and son of two MDs, challenged the industry to invest aggressively in health care. Cisco has seen a 92% increase in health care costs over the past three years even though their workforce is young, with few retirees. He believes strategic investment in health care IT now can drive down 23% of the costs by improving productivity, but he declared, “it’s not how much you spend, it’s do you have the willingness to invest in the process change that will leverage the technology investment and deliver the productivity gains needed to reduce the growth of health care costs.”
Chambers was followed by panelists from McKesson, Cerner, IBM, General Electric and Computer Sciences Corp., all effusively praising Dr. Brailer and declaring their readiness to support the open standards and interoperability of the NHII. These technology leaders were followed by leadership panelists from payer, clinical, consumer and foundation communities. Organisations represented included Blue Cross Blue Shield, AMA, AAFP, ANA, AARP, AMIA, AHIMA and HIMSS. In particular, Charles Safran, President of AMIA, recognised Dr. Brailer as the 1983 winner of the annual AMIA competition for research papers from Medical Students.
Newt Gingrich spoke on the urgent need to transform health care. He said, “People die from paper records. And if we have a pandemic or a bioterrorist attack, it will be worse.” He urged the attendees to build a universal, web based, real time NHII.