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Press Releases: Government to Business

May 6, 2004

Secretary Thompson, Seeking Fastest Possible Results, Names First Health Information Technology Coordinator

HHS Also Announces Milestones in Developing Health IT

Saying that "health information technology has the potential to greatly improve health care even as it yields huge savings," HHS Secretary Tommy G. Thompson today announced the appointment of David J. Brailer, M.D., Ph.D., to serve as National Health Information Technology Coordinator. This is a new position at HHS, created by President Bush last week to coordinate the nation’s health information technology efforts.

Secretary Thompson announced the appointment at a Secretarial Summit on health information technology (IT) convened in Washington today.

"Health information technology promises huge benefits, and we need to move quickly across many fronts to capture these benefits," Secretary Thompson said. "I asked the leaders of the health IT community to join me at this summit to see how we can press down on the accelerator and bring about the benefits of health IT even faster. The benefits are enormous, but the task is also enormously complex. We need more than a business-as-usual approach."

  • At the summit, Secretary Thompson also announced several new accomplishments in developing standards to help bring about electronic medical records and other health IT benefits:
    • HHS and other federal agencies will adopt 15 additional standards agreed to by the Consolidated Health Informatics (CHI) initiative to allow for the electronic exchange of clinical health information across the federal government.
    • HHS also announced that, starting today, the medical vocabulary known as SNOMED CT can be downloaded for free for use in the United States through HHS’ National Library of Medicine. SNOMED CT, created by the College of American Pathologists, is a key clinical language standard needed for a national health information infrastructure.
    • With HHS support, the voluntary international health standards-setting organization known as Health Level 7 (HL7) today is announcing a favorable vote on a functional model and standards for the electronic health record. The model is a significant step toward establishing nationwide guidelines for electronic health records.

Today’s actions move the nation closer to a national, interoperable health information infrastructure that would allow quick, reliable and secure access to information needed for patient care, while protecting patient privacy. Such a system would allow a doctor or health care provider to access an always-up-to-date electronic health record of a patient who has agreed to be part of the system, regardless of when and where the patient receives care. President Bush last week established a national goal of assuring that most Americans have electronic health records within 10 years.

Today’s summit brought together more than 100 leaders in the area of health information technology, including Veterans Affairs Secretary Anthony J. Principi, former Speaker of the House Newt Gingrich and leaders in IT and health care, health information exchange projects, employers, physicians, health plans and patient advocates. Secretary Thompson convened the meeting to brainstorm on ways to speed up the development and implementation of electronic health records and local health information infrastructures.

National Health Information Technology Coordinator

Dr. Brailer, a national leader in harnessing health IT to promote safe, quality and efficient health care, will head a new office at HHS, created by a directive from President Bush. The office will support efforts across government and in the private sector to develop the standards and infrastructure to allow more effective use of information technology to promote higher quality care and reduce health care costs. One of the office’s first tasks will be to study options to create incentives in Medicare and other HHS programs to encourage the private sector to adopt interoperable electronic health records. It is estimated that a national health information network can save about $140 billion per year through improved care and reduced duplication of medical tests.

President Bush already has proposed an additional $50 million in his fiscal year 2005 budget to support the development of local health information networks, which would enable a physician treating a patient to have information about all other care the patient has received. These local networks would be able to communicate with one another in a dispersed national network of local and regional systems.

In addition, the new office will work closely with the other components of HHS that are responsible for medical privacy and security regulations to ensure these efforts continue to secure and protect individually identifiable health information. The office will prepare recommendations on methods to assure that the interoperable health information technology appropriately addresses privacy and security issues, such as appropriate authorization, authentication and encryption of data that is being transmitted over the Internet.

Dr. Brailer currently is a senior fellow at Health Technology Center in San Francisco, where he has advised various regional and national efforts on IT and health information exchange. He previously served for 10 years as chairman and CEO of CareScience Inc., one of the nation’s leading health care management companies. While at CareScience, Dr. Brailer designed and oversaw the development of the health information exchange technology implemented in Santa Barbara County, Calif. Dr. Brailer holds doctoral degrees in both medicine and economics.

"Dr. Brailer is one of the pioneers in developing community health information exchanges and will now help jumpstart our efforts to improve the quality of care available across America by speeding the nation’s progress in implementing these kinds of solutions," Secretary Thompson said.

Consolidated Health Informatics Initiative

As part of the CHI initiative, HHS and the other federal departments that deliver health care services -- the Departments of Defense and Veterans Affairs -- are working with other federal agencies to identify appropriate, existing data standards and to endorse them for use across the federal health care sector.

The 15 new standards build on the existing set of five standards adopted in March 2003. The new standards agreed to by federal agencies will be used as agencies develop and implement new information technology systems.

"Today we sit at the cusp of creating a ‘virtual health system’, one that will greatly improve the quality, safety and efficiency of health care for Americans through effective use of electronic health records, personal health records, and standards-based information technology tools," said Veterans Affairs Secretary Anthony J. Principi. "Two years of close collaboration among VA, HHS and DoD have brought about this historic opportunity. The federal government has taken a strong leadership role and helped lay the critical groundwork for a national public-private health IT partnership."

"Adoption of these standards will increase our ability to share medical data within the health community," said Dr. William Winkenwerder, assistant secretary of defense for health affairs. "Interoperability through standards will enable us to share electronic patient records which will improve the quality of health care. Better access to medical information means improvements in patient safety and military medical readiness, and a reduction in health care costs."

The CHI initiative is part of President Bush’s E-Gov Initiatives, which includes a cross-government effort to develop a federal health architecture that would encompass the CHI standards, as well as compatible software and business systems to promote efficient, effective communication to improve quality of care.

"The CHI standards will help improve quality of care by making it easier to coordinate care and exchange needed information across federal agencies and will serve as a model for the private sector," said Karen Evans, administrator for E-Government and Information Technology within the Office of Management and Budget.

  • The specific new standards are:
    • Health Level 7 (HL7) vocabulary standards for demographic information, units of measure, immunizations, and clinical encounters, and HL7’s Clinical Document Architecture standard for text based reports. (Five standards.)
    • The College of American Pathologists Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) for laboratory result contents, non-laboratory interventions and procedures, anatomy, diagnosis and problems, and nursing. HHS is making SNOMED-CT available for use in the United States at no charge to users. (Five standards.)
    • Laboratory Logical Observation Identifier Name Codes (LOINC) to standardize the electronic exchange of laboratory test orders and drug label section headers. (One standard.)
    • The Health Insurance Portability and Accountability Act (HIPAA) transactions and code sets for electronic exchange of health related information to perform billing or administrative functions. These are the same standards now required under HIPAA for health plans, health care clearinghouses and those health care providers who engage in certain electronic transactions. (One standard.)
    • A set of federal terminologies related to medications, including the Food and Drug Administration’s names and codes for ingredients, manufactured dosage forms, drug products and medication packages, the National Library of Medicine’s RxNORM for describing clinical drugs, and the Veterans Administration’s National Drug File Reference Terminology (NDF-RT) for specific drug classifications. (One standard.)
    • The Human Gene Nomenclature (HUGN) for exchanging information regarding the role of genes in biomedical research in the federal health sector. (One standard.)
    • The Environmental Protection Agency’s Substance Registry System for non- medicinal chemicals of importance to health care. (One standard.)

SNOMED CT Medical Vocabulary

Secretary Thompson also announced that SNOMED CT, a standardized medical vocabulary is now available for download as part of the National Library of Medicine’s Unified Medical Language System (UMLS) Metathesaurus at The vocabulary is available free for anyone in the United States. Users must register via the Web for a free UMLS license before downloading the data or requesting a copy on DVD.

With terms for more than 300,000 current medical concepts, the College’s standardized system has been recognized as the world’s most comprehensive clinical terminology database available. With its free availability within the United States, it is now possible for health care providers, hospitals, insurance companies, public health departments, medical research facilities and others to easily incorporate this uniform terminology system into their information systems.

More information about HHS’ efforts to promote health IT is available at

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