Analysis & Commentary:

eHealth INITIATIVE OFFERS BLUEPRINT

The eHealth Initiative, a nonprofit consortium of more than 50 leading health care companies, called for a greatly expanded use of digital information technology (IT) and Internet-based communications to help ensure a fast and effective response to large-scale bioterrorism. The consortium is offering a blueprint of how the greater use of IT can enhance and support the U.S. public health infrastructure.

Companies such as CareGroup HealthCare System, EDS, IBM, Johnson & Johnson, McKesson Corporation, Medscape, Pfizer Health Solutions, Siemens, VHA Inc and others formed the consortium earlier this year with the goal of improving the quality, safety and cost-effectiveness of every aspect of the American health care system, through the use of IT.

Coordinated Use of Existing IT Emphasized

At its annual meeting, the eHealth Initiative underscored that the coordinated use of IT is a crucial building block in efforts to enhance the speed and accuracy of bioterrorism surveillance and public health response. Members of the eHealth Initiative cited few technical barriers and relatively modest costs in using Web-based communications to better link hospitals, medical centers, public health and law enforcement agencies, pharmaceutical and insurance companies and even primary care physician offices. Russell Ricci, M.D., general manager of IBM's Healthcare Industry business and newlyappointed Chairman of the eHealth Initiative said, "To successfully address the challenge of bioterrorism we must work together to make improvements to the public health care infrastructure. Building upon the existing infrastructure and coupling it with the Internet as a global communications backbone, will both improve the speed of detection of and the coordination of responses to a bioterrorist action." He stressed that "It makes more sense to expand and link existing clinical information and response systems rather than try to construct a whole new infrastructure from scratch."

To achieve this goal, the eHealth Initiative is seeking to work and coordinate with health agencies within the government. Many of these organizations already have well-established systems in place and together they provide about half the funding for health care in America. "Leveraging both private and public sector expertise in the public health fight against bioterrorism is a smart and cost-effective strategy" said Ricci.

Panel of Experts Identifies Current Challenges

A distinguished panel of experts including Ricci; Helga Rippen, MD, MPH, director of RAND's Science and Technology Policy Institute; and Alana D. Knudson-Buresh, PhD, Senior Director, Public Health Information and Infrastructure Policy for the Association of State and Territorial Health Officials discussed current challenges that include: (1) fragmented communications among numerous federal government, medical, and public health and law enforcement agencies responsible for bioterrorist surveillance and response; (2) difficulties in rapidly coordinating activities among these same groups; and (3) a lack of investment in basic information technology by some health care stakeholders.

John Halamka, M.D., chief information officer of CareGroup HealthCare System, an eHealth Initiative member company and a leader in using technology to more effectively deliver health care, said "In a situation in which just one or two people are infected, the lack of fast communication and coordination isn't that obvious. But a large scale attack would emphasize these weak points." Halamka stresses that "if we can eliminate pockets of delay with enhanced information technology strategies and tools, consumers and the public health system will benefit."

EHealth Initiative IT Bioterrorism Blueprint

The eHealth Initiative has put forth a blueprint to support and advance our nation's preparedness and response. Randy Spratt, senior vice president, technology and standards of McKesson Corporation and an eHealth Initiative Board member said that the blueprint "recognizes that many of the components for building a digital-based public health infrastructure already exist or can be rapidly evolved from information technology products on the market today." He also emphasized that "more importantly, eHealth Initiative members believe that any improvement in the information technology backbone of the public health infrastructure would generate much-needed and wide-ranging improvements in quality and cost-effectiveness throughout the nation's entire health care system."

The eHealth Initiative blueprint specifically calls for:

• Working with federal government stakeholders to identify appropriate methods for providing a nationwide, integrated information and communications system with access by all appropriate federal, state and local agencies, healthcare providers and payors;
• Convening public and private-sector stakeholders to discuss and develop solutions centered around how to better identify and respond to a bioterrorist attack. Any strategy should involve both the private sector and all appropriate public agencies including, but not limited to: the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Veterans' Health Administration and other military health facilities, the Food and Drug Administration, the Federal Emergency Management Administration, and the Department of Health and Human Services;
• Coupling the Internet with and building upon existing hospital information technology networks as a backbone for communicating better within and across hospitals and physician offices and externally to appropriate public health organizations about the emergence of a bioterrorist threat;
• Leveraging existing information technology to improve key processes critical to our nation's response to a bioterrorist threat, including:
• Real-time automated data collection tools to allow for rapid collection of information related to symptoms and diagnosis;
• Data mining, repository and analysis applications designed to rapidly extract, aggregate, and analyze prescription, lab, billing and other critical diagnostic information within and across multiple organizations;
• Communication tools to support rapid transmission of information;
• Web-based tools to assist in educating "first responders" -- most likely the primary care and emergency room physicians--to equip them with critical information needed, including knowledge to assist in detection of possible bioterrorism-caused illnesses; appropriate treatment protocols; communications support for patients affected; and standardized processes for reporting and information dissemination; and -
• Enhanced supply, inventory, and distribution management systems for prescription drugs and other consumables.

About the eHealth Initiative

The eHealth Initiative is a national not-for-profit trade and advocacy group created to provide a unified voice for the health care industry on eHealth and technology-related issues. Led by chief executive officer Janet Marchibroda, its mission is to improve the quality, safety, and cost-effectiveness of health care by promoting the rapid discovery, development, roll-out and adoption of digital health care.

Its members represent many of the stakeholders in the health care industry, with interests in improving the health care system through the use of technology, including eHealth and technology organizations, health systems, health care providers, pharmaceutical and medical device manufacturers, service providers, and research institutions.

For more information about the eHealth Initiative, call 202-663-8099 or visit www.ehealthinitiative.org.

Contact Ticia Gerber, 202-663-8711.