Connecting for Health creates incremental roadmap for achieving electronic connectivity in health care

New York 21 January 2004Connecting for Health, an extraordinary collaborative of public and private stakeholders, will launch a continuation of its effort to promote electronic connectivity in the health care field in order to improve patient care and lower costs while protecting patient privacy. At a meeting in New York, the project's Steering Group, comprised of more than 50 leaders and decision makers in the health care industry, renewed their commitment to advancing the use of electronic connectivity in health care.

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The critical role of information technology in combating medical error and improving patient safety has been highlighted in the past by the Institute of Medicine and most recently by President Bush in his State of the Union address. The Steering Group also committed to create an incremental roadmap to achieving electronic connectivity. The roadmap is necessary for prioritizing actions, fostering innovation and leveraging efforts across the public and private sector. Connecting for Health, which was established by the Markle Foundation, also announced that the Robert Wood Johnson Foundation would be joining Markle as a funding partner in the next phase of its work.

"The success of Connecting for Health's initial phase, which broke through the long-standing impasse related to data standards, was based on finding achievable milestones and focusing on areas where we could obtain consensus, which is how we are going to proceed now in developing our roadmap", stated Dr. Carol Diamond, Managing Director at the Markle Foundation. "The real potential of this initiative however, rests on its collaborative approach and the addition of the Robert Wood Johnson Foundation illustrates the extraordinary nature of Connecting for Health. The Robert Wood Johnson Foundation has a long and distinguished history of improving health and health care in this country and we are honoured to be partnering with them."

"Patients deserve to have a safe and reliable health care system that provides quality care. The only way we're going to get there is if public and private sectors come together to create an interoperable electronic infrastructure for health care", stated John Lumpkin, M.D., MPH, Senior Vice President of the Robert Wood Johnson Foundation and Chair of the National Committee on Vital and Health Statistics. "We'll need to put our greatest efforts towards what we can all agree on and at the same time work towards common ground in areas where we disagree."

Connecting for Health brings with it a continued commitment from many of the United States' foremost leaders in the public and private sector. The Connecting for Health Steering Group, which met in New York, is led by Daniel Garrett, vice president and managing director of Computer Sciences Corporation's Global Health Solutions Practice; Herb Pardes, M.D., President and CEO, New York Presbyterian Hospital; John Lumpkin, M.D., MPH, Senior Vice President for Health Care, Robert Wood Johnson Foundation; and Carol Diamond, M.D., MPH, Managing Director, Markle Foundation's Information Technology for Better Health Programme. Janet Marchibroda, Executive Director of the Foundation for the eHealth Initiative, serves as the Executive Director.

"We have an opportunity to bring the innovation and expertise of the private sector together with the public sector to help drive our health care system toward a common goal of interoperable information technology for patient safety and health care quality", stated Dan Garrett, who was named an Executive Vice Chair of the Steering Group. "This initiative is a unique opportunity to maximize the complementary expertise and experience of the public and private sectors."

"The health care industry needs to be able to deliver information where and when it is needed in a private and secure manner if we are to provide the best possible care to patients", stated Herb Pardes, also an Executive Vice Chair of Connecting for Health. "By acting collaboratively and decisively, I believe that the next phase of Connecting for Health's work will bring us even closer to an interoperable health care network that will lower costs and improve patient care while at the same time protect patient privacy."

The continuation of the Connecting for Health initiative comes as a result of strong support in the public and private sectors for ongoing collaborative efforts that can catalyze action toward an electronic interoperable health care information infrastructure so vital to addressing the safety, quality and effectiveness of health care in the United States. The first phase of Connecting for Health was a $2 million initiative supported by the Markle Foundation. In a next phase, Connecting for Health will have similar support from Markle and will also benefit from the additional resources and expertise of the Robert Wood Johnson Foundation.

Connecting for Health will now build on the ground-breaking achievements of its earlier work by identifying, tackling and testing solutions to the technical and policy barriers. Specific goals of Phase II include:

  1. A roadmap detailing an action agenda of achievable objectives over the next 12 months that will leverage activities between public and private health care sectors toward a health information infrastructure that fosters innovation, encourages information sharing, and provides exchange of necessary health information in a private and secure manner.
  2. Challenging barriers that impede patient-centred information sharing within a series of Working Groups. Specific areas of focus will be on understanding the business and organisational issues of community-based information exchange, the issues relevant to sharing electronic information with patients, and certain aspects of technical interoperability. The working groups and their leaders are:
    • Working Group on Electronic Health and Personal Health Record chaired by: David Lansky, Ph.D., president of the Foundation for Accountability (FACCT).
    • Working Group on Accurately Linking Health Information for Safety and Quality chaired by Clay Shirky, Adjunct Professor New York University Interactive Telecommunications Programme.
    • Expert Panel on Organisational Models and Financial Sustainability of Community-Based Health Information Exchange chaired by David Brailer, M.D., Ph.D., Senior Fellow for Information Technology and Quality of Care at the Health Technology Center.
    • Expert Panel on Data Exchange Standards chaired by Wes Rishel, Vice President and Research Area Director, Gartner and Past Chair HL-7.
  3. A Demonstration Project is planned to test and evaluate the working groups' products in real-world settings.

Although one of every seven dollars spent on goods or services in the United States goes to health care, the current system is highly fragmented and, in the words of the Institute of Medicine, lacks even "rudimentary" clinical information capabilities. Vital data sits in paper-based medical records that can neither be accessed easily nor combined into an integrated form to present a clear and complete picture of patient care. This information inadequacy is pervasive. Everyone who uses the system constantly confronts large gaps in needed information, be it at the doctor's office, the hospital or at government agencies charged with protecting public health.

The problem of adverse drug events alone represents a sizable opportunity for information systems. According to an estimate from the Institute of Medicine (IOM), an estimated 770.000 people are injured due to adverse drug events annually in the United States and up to 70 percent of these incidents may be avoidable. According to the Center for Information Technology Leadership, nationwide adoption of advanced computerized order entry systems in ambulatory care could eliminate up to two million adverse drug events and 190.000 hospitalizations per year, and could save up to $44 billion annually in reduced medication, radiology, laboratory, and hospitalization expenditures.

Connecting for Health, a public-private collaborative, was originally convened by the Markle Foundation in September of 2002. The initiative had a nine month goal of serving as a catalyst for changes that would rapidly clear the way for an interoperable health information infrastructure. It was designed to address the challenges of mobilizing health information in order to improve quality, conduct timely research, empower patients to become full participants in their care, and bolster the public health infrastructure.

Connecting for Health's Steering Group, whose members represent a driving force in health care, agreed for the first time in September of 2002 on the voluntary adoption of an initial set of data standards and communication protocols for the sharing of health care information. The United States Government announced its adoption of these same standards in March of 2003. Connecting For Health's achievements in just nine months toward the adoption of health care data standards represents progress that has eluded the health care industry for more than a decade.

Over a nine month period, ending in June 2003, Connecting for Health:

  • Built consensus on an initial set of health care data standards.
  • Developed case studies of places where privacy and security practices may provide a model for others.
  • Advanced the understanding of the consumer's role in an interconnected health care system by defining the personal health record and its use.

Since Connecting for Health began its work in September of 2002, the importance of interoperability to health care safety and quality has been publicly endorsed by leaders including President Bush, Secretary of U.S. Health and Human Services Tommy G. Thompson, U.S. Food and Drug Administration Commissioner Mark B. McClellan and a host of key stakeholder organisations including the American Hospital Association. Connecting for Health's action-oriented agenda, meanwhile, has drawn wide support.

Emerging information and communication technologies possess enormous potential to improve people's lives. The Markle Foundation works to realize this potential and to accelerate the use of these technologies to address critical public needs, at present principally in the areas of health care and national security. The Markle Foundation's overarching goal in the health area is to accelerate the rate at which information technology enables consumers and the health system that supports them to improve health and health care. The Foundation's goal is to ensure that the extraordinary potential of 21st century information technology to improve the health and health care of each citizen is translated into everyday use as quickly and as effectively as possible.

The Robert Wood Johnson Foundation (RWJF) seeks to improve the health and health care of all Americans. To achieve the most impact with its funds, RWJF prioritizes grants into four goal areas: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; to reduce the personal, social and economic harm caused by substance abuse such as tobacco, alcohol, and illicit drugs. To accomplish these goals, RWJF uses a variety of strategies. RWJF supports training, education, research, excluding biomedical research, and projects that demonstrate the effective delivery of health care and concentrates on health care systems and the conditions that promote better health.


Leslie Versweyveld

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