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e-Health Initiative Update: Proceedings From the e-Health Technology Summit

Internationally recognized for his work in outcomes management, medical staff development, and qualityof-care improvement, David B. Nash is the Dr Raymond C. and Doris N. Grandon Professor and chairman of the Department of Health Policy at Jefferson Medical School of Thomas Jefferson University in Philadelphia, one of only a handful of medical schools with an endowed chair of health policy. His appointments to the Joint Commission on Accreditation of Healthcare Organizations Advisory Committee on Performance Measurement, the CIGNA Privacy Board, and the Board of Directors of the Disease Management Association of America place him at the center of 3 key national groups focusing on quality measurement and improvement. In addition to being the current editor-in-chief of the American Journal of Medical Quality, he serves in a similar capacity for the journals P&T, Disease Management, and Biotechnology Healthcare. A seemingly limitless amount of information is available to each of us electronically; from personal banking and investments to local and international news to professional and personal communications, we are a wired society! Consider the striking contrast between our technology-driven environment and our individual health records. While we can access our email, our hometown news, and our bank account balances from another continent, we cannot access a complete record of encounters with our different health care providers in the same city because the capability does not exist. Sadly, universal electronic health records (EHRs) are still a long way off. While more than three quarters of US physicians’ offices had moved to electronic billing by 2003, slightly more than 17% used an EHR and less than 8% used electronic prescribing systems. We all recall that the 2003 Institute of Medicine report Patient Safety: Achieving a New Standard for Care called for a national health information infrastructure to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. Such an infrastructure would also accrue patient safety information for use in designing safer care delivery systems. In April 2004, the Bush administration responded by issuing a challenge to create a national EHR within 10 years. Appointed as national coordinator for health information technology (HIT) the following month, Dr David Brailer undertook a daunting mission building on a solid base of public and private sector activities including