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Friday, April 17, 2009

Of Moon Shots and Progress

I've previously described George Bush's executive order 13335 issued in early 2004 as the initial step in moon-shot for healthcare. In announcing this order, he called for most Americans to have secure, interoperable electronic health records by 2014. I'm not sure his announcement was as stirring and Kennedy's in 1961, but it's still been a tumultuous and exiting time for those of us involved in healthcare.

If you've been tracking what's been going on at the national level for the past five or six years, you are fairly aware of many of the things that have occured since that order, including the creation of ANSI/HITSP as a body selecting standards, CCHIT certifying EHR products, multiple NHIN projects demonstrating the ability of those standards to connect the nation together, HISPC activities to rationalize policy, recognition of selected standards, testing of those implementations, and their actual use in real world projects. The incorporation of much of what was championed by that executive order, and executive order 13410 which followed it into the HITECH legislation enacted under the America Reinvestment and Recover Act of 2009 is yet another significant step forward for all of us.

As we move forward, I've heard several complaints about the "lack of progress", the gist of which are that "we aren't there yet". We still have a ways to go before we are done, as was anticipated when this was originally outlined as a 10-year goal. We are at the mid-point of that goal, and I ask you to look at the successes we've already seen. Many of the HITSP specifications not just prototyped, tested, or piloted, but put into real production and use, and available in real-world products. We'll be hearing later this year from some of those HIEs in the real world who have already implemented HITSP specifications. This year, the CCHIT certification criteria includes several HITSP specifications for the first time. I fully expect to see numerous systems that have already demonstrated their ablilty to implement HITSP specifications become certified for the first time.

NASA took six and a half years from Kennedy's commitment to land men on the moon before the first unmanned launch of the Saturn V rocket into low earth orbit. HITSP's managed to accomplish a similar feat in only 4 years since it's inception.

So in response to "Are we there yet?" I answer "No, we are about halfway, but be patient. We will arrive in due time."


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