HHS formally recognizes e-records unit

The Health and Human Services secretary on Friday announced a new department regime that formally recognizes the office charged with developing a national infrastructure for electronic health records.

President Bush issued an executive order in April 2004 to create the position of the national coordinator for health information technology, which is housed in the department. David Brailer was appointed as the initiative's coordinator in May of that year. However, until Friday his unit lacked an official structure and supporting offices.

The announcement in the Federal Register codifies a formal structure supporting the work underway in the office of the national health IT coordinator, a spokeswoman in Brailer's office said. It reinforces Brailer's position and establishes four supporting offices.

The structure also reflects the recent requests for contract proposals to develop a standards-based infrastructure to securely house and transfer electronic health records among systems that can work together. Those contracts are expected to be awarded this fall.

"This formal structure will give [the IT unit] the firepower it needs to move forward," said Janet Marchibroda, chief executive officer of the eHealth Initiative and its Foundation.

Brailer's position will serve under the newly titled immediate office of the national coordinator. He will serve as the executive director of the new offices, charged with aiding and introducing a national medical Internet capable of connecting doctors, hospitals and patients to e-health records. A director will oversee each new office.

Under the regime, the office of health IT adoption will coordinate strategies and offer incentives for the IT adoption among practitioners, providers and hospitals. The office also will create personal health IT tools while promoting consumer choice for health care, according to the notice.

The health IT office will foster the transfer of technologies to the public sector. The office will track the benefits and the costs associated with the adoption of health IT and will oversee the certification process for related technologies.

The office of interoperability and standards will be responsible for fostering the "mechanisms that support the secure and seamless exchange of health information" via the development and use of technology standards, certified technologies and other requirements to efficiently implement the infrastructure for e-health records.

The interoperability unit also will work with other federal agencies to ensure that federal systems are compatible with the national medical Internet, and it will be responsible for harmonizing security and privacy practices.

The office of programs and coordination will be responsible for coordinating the dissemination, integration and promotion of initiatives within the federal government and to the public through outreach campaigns to consumers.

Security and privacy concerns will be addressed in the policy and research office, which will be responsible for ensuring the smooth transition of health IT policies and examining the policy implications of health IT initiatives. The office also will study the impact of health IT on public and private business practices.

New staff announcements were not made in conjunction with the notice. It is unclear how soon the positions will be filled, the spokeswoman in Brailer's office said.