Report Requested by Bush Administration Recommends Framework for National Health Information Network

A group of 13 health and information technology organizations on Tuesday in a report requested by the Bush administration recommended a "common framework" for a national health information network, the New York Times reports.

According to the 54-page report, to improve health care and reduce costs, physicians should have the ability to exchange patient information with hospitals, laboratories, specialists, health insurers and researchers. The recommendation "borrows heavily from the technical and policy approach of the Internet," and "one goal" is to establish a network similar to an Internet-based e-mail system, in which all participants share standard technology, the Times reports.

However, the report said that a national network should not include a central database of patient information or require "health ID cards" for individuals, as some have recommended. The federal government should participate in initial financial and technical support of the network but should later establish a separate "standards and policy entity" to administer the network, according to the report.

In addition, the report said that patients should control their medical records and have the ability to decide whether to participate in clinical trials.

David Lansky, a director of the health program at the Markle Foundation -- which coordinated the report -- said, "The issue we tried to address is how do we mobilize America's incredibly fragmented health system to really get this done."

Other organizations involved with the report include the American Health Information Management Association, the Healthcare Information and Management Systems Society and the Liberty Alliance Project.

In a study published on Wednesday in the journal Health Affairs, researchers from the Center for Information Technology Leadership at Partners HealthCare System estimated that a national network would save the health care industry a net of $78 billion annually by 2015.

According to the study, physicians and hospitals would have initial costs of $276 billion over 10 years to implement the network. The study said that access to the network must remain open to ensure that health care professionals do not have to purchase high-cost software to share information.

"If we're not careful, we'll have little islands of excellence that don't talk to each other," lead author Jan Walker, executive director of CITL, said.

Blackford Middleton, chair of CITL and assistant professor at Harvard Medical School, said, "More aggressive leadership at the national level is needed, and time is of the essence" (Lohr, New York Times, 1/19).