IOM calls on federal funds for technology demo projects

A report by the council lays out the groundwork for the creation of a national health information network.

By Tyler Chin, amednews staff. Dec. 16, 2002.

The Institute of Medicine has recommended that the federal government fund up to 10 health care technology demonstration projects in 2003 that would serve as "building blocks" to a national health information structure.

The projects would involve the creation of state-of-the-art health care information and communication infrastructures that patients, doctors and others could use to communicate with each other, according to an IOM report, "Fostering Rapid Advances in Health Care: Learning from System Demonstrations."

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The report, released in response to a request by Dept. of Health and Human Services Secretary Tommy Thompson for "bold ideas" to address the serious problems facing the health care industry, identified information technology as one of five areas offering the greatest potential for improving the American health system.

The IOM also recommended that the government fund demonstration projects that might offer models for expanded insurance coverage, liability reform, chronic-disease management and primary care enhancement.

Other federal advisory bodies have long recommended creation of a national health information infrastructure, but the IOM report lays out a road map to reach that objective, said William W. Stead, MD, director of the Informatics Center at Vanderbilt University Medical Center in Nashville, Tenn., and member of the IOM committee that wrote the report.

"The thing that is different about this report is that, to date, most of the things that have been done in terms of health care information technology have really been facility-based," said Dr. Stead, who also is associate vice chancellor for health affairs at VUMC.

"They tend to focus on the workings of a particular hospital or practice. What we're really suggesting is that we've got to first bring together the people that take care of a population of patients [within a certain region] and connect the information resources that exist, and then begin using that information in automated tools and practice."

Road map for project rollout

In addition to the initial demonstration projects slated for 2003, the IOM also recommended that the government fund a second wave of projects in 2005 that would provide the "initial nodes" for a national health information infrastructure.

It suggested that each project would have three phases. The first phase -- planning -- would create a public-private partnership, the second would include the building of a secure communication platform and the third phase would involve developing and rolling out applications that would computerize all or nearly all types of patient data.

While the final phase would be funded by the public-private partnership, the first two phases would be funded by the government.

To help accelerate industry adoption of technology, the IOM also suggested that the government lead an effort to create data standards that would let disparate information systems talk to each other and that the government -- and other parties -- develop policies to pay doctors and others for delivering health care services via electronic methods, including the Web and telemedicine.

"For this strategy to result in broad-based health system reform, however, we must both plant the seeds of innovation to create an environment that will allow success to proliferate," the report said. "If the federal government fails to play a proactive role in creating an environment that nurtures change and success, the ambitious demonstration agenda will have minimal impact on the overall health care sector."