National ehealth network prototype due soon

Robert Kolodner was named interim national coordinator for health IT at the U.S. Department of Health and Human Services (HHS) in September, replacing David Brailer, the first person to hold the post. Kolodner was previously chief health informatics officer at the U.S. Department of Veterans Affairs (VA). In an interview with Computerworld this week, Kolodner talked about the federal government’s effort to encourage widespread adoption of electronic medical records (EMR) technology and its plans to develop a Nationwide Health Information Network (NHIN) for sharing health data.

Excerpts from that interview follow:

What is the status of the NHIN effort today? David Brailer and the team laid out a very aggressive agenda. We are nearing the end of the contracts [to develop NHIN prototypes]. We already have collaboration going with the National Committee on Vital and Health Statistics, and they have been looking at some of the [NHIN] functional requirements. We will be having the demonstrations of prototypes in January. From the prototypes, we will draw a necessary set of requirements…to move us forward to a functioning NHIN in the future.

What do the prototypes look like? We are still in the process of reviewing those. We’re in the process of finalizing the next steps and hope within the next month we’ll be able to let everyone know what we’re planning on doing.

What are the biggest challenges to President Bush’s mandate that all citizens have an EMR by 2014 and that a national network be created for sharing those EMRs? There are a couple [of] barriers that form the basis of our activities within the office. A key part has been the lack of standards for data and technical support for the network. We’re in the process of developing and growing those. We also have the process [for adopting] those standards. The [Certification Commission for Healthcare Information Technology] is the means by which we encourage [EMR] vendors to build those standards into their products. Thirty-five products have been certified, and we expect another round before going to next year’s criteria.

Does your experience in the VA indicate that you will not depend on the private sector to take the lead in the NHIN effort? If you look at all the initiatives we have in place, they are public/private collaborations and activities. We have very active participation in the effort with the public and private sectors, with the majority being the private sector. The NHIN work is done by contract; It is all done in the private sector.

You were appointed as “interim” coordinator in September. What is your status now? I was detailed at the [Health and Human Services] secretary’s request from the VA. The detail is for a few months. I am in the middle of the detail now.

How will regional health information organizations fit into the NHIN plan? That is an emerging model that we see. We expect the activity needs to occur at a local, regional and state level. The NHIN is then an enabler that links across those regional activities and makes sure they are fully interoperable.

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