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Whoops, Hollers, and Health IT: Medical Data Starts Moving from Doc to Doc

By John Reichard, CQ HealthBeat Editor

February 2, 2011 -- The Humphrey Building auditorium, with its dim lighting, is one of the dreariest venues for press conferences in Washington. So it bordered on the bizarre when a midday Health and Human Services press event on health information technology sounded more like the opening moments of a rock show at the 9:30 Club.

Fueling the excitement—whoops and hollers greeted each new speaker at the one-hour event—was the news that digitized health data has begun to flow from doctor to doctor or between doctors and hospitals under standards developed by Direct Project, a government-industry collaboration launched less than a year ago.

The standards aim to support the secure exchange of basic clinical information and public health data and spur the development of a nationwide health data exchange system.

HHS Chief Technology Officer Todd Park variously referred to the joint effort as "an explosion of mojo" and a "soon to be legendary" example of government-industry collaboration. David Blumenthal, the national coordinator for health IT who was hailed by another excited speaker as "a rock star," attempted to convey the importance of the project to the technophobic press.

Blumenthal (whose brother Richard is the new Democratic senator from Connecticut) explained that it's one thing to convert medical records into electronic form but quite another to actually transmit the digitized data from one health care setting to another.

Providers, government officials, and competing vendors and insurers have to agree on common standards for organizing medical information, easing its flow along computer systems and securing its privacy. "This is a way to get it out of your computer into someone else's computer," Blumenthal said.

Blumenthal made a couple of other attempts to explain Direct Project in layman's terms.

"I'm trying to think of analogies here," he said. "If that system is a bridge over a river, then what we're announcing today is a huge pillar for that bridge." It is going to be "one of the elementary methods of letting information travel," he said.

Direct Project is part of a larger project, he said—to create "a nationwide, interoperable, private and secure electronic health information system. That set of words has kind of a numbing quality to it," Blumenthal acknowledged wryly.

"If you talk to people, one of the things they most want from their health care system is for their doctors and nurses who are located in different places to be able to share what they know about them; to be able to share the X-rays, the laboratory results, the notes, so that they don't always have to fill out that clipboard, they don't always have to repeat what drugs they're on—that somehow the health care system retains what the health care system knows about them."

Blumenthal's third time, perhaps, was the charm.

He resorted to a highway analogy. "This is a lane in the information highway. It's not the only lane, but it's one lane that is easy to use, it's quick, the on ramps are simple, the off ramps are simple," he said.

An example of that is that the standards developed allow medical data to be transmitted via secure e-mail with attachments rather than by fax and through snail mail.

Some 200 participants from 60 companies and other organizations took part in development of the standards, which are being tested this year with the goal of formally adopting them and making them widely available for providers in 2012.

"It makes government a platform for innovation by those who really know the field," said Aneesh Chopra, White House technology officer. "Then it makes their work available for the public good, and it serves as a basis for competition among the very entities that brought it about."

Pilot programs that rely on Direct Project-based standards are already under way in Minnesota and Rhode Island. More pilots are planned in Tennessee, New York, Connecticut, Oklahoma, California, and south Texas.

In the Minnesota project, the Hennepin County Medical Center has been successfully sending immunization records to the Minnesota Department of Health. The Rhode Island project involves sending referrals from primary care doctors to specialists electronically, and making electronic health records available to providers, with the patient's consent, widely through a statewide information data exchange system.

Microsoft's Sean Nolan, who said he was "super excited to be here," said that next week the company's Health Vault product will be wired in a way that allows its users to obtain their digitized medical data more broadly thanks to the Direct Project standards. Health Vault is a free online product that allows individual consumers to gather their medical data in a single place and share it electronically.

Mark Briggs of VisionShare, a 10-year-old company that develops software to allow providers and insurers to transmit medical and financial data electronically, said at the briefing that "we're announcing today that VisionShare is making an investment of up to $50 million over the next year or so to provide the ability for all physicians, hospitals, and other health care providers across the country to join the network and transact over Direct."

That announcement was greeted with all the enthusiasm of an appreciative audience after a solid solo guitar riff.

"Wow!" another speaker interjected loudly, to the chuckles and applause of Direct Project participants who filled the front seats of the briefing room.

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