Not Huxley, but Shakespeare

I woke up this morning, and the world had seemingly changed overnight. I look forward to a great deal of that change, especially the investments in Healthcare IT that have been described elsewhere by the Obama campaign (see Presidential Politics and Healthcare IT).

I also look forward to change occuring over the next year inside HITSP. My sense is that much of that change will come from inside rather than be imposed from outside, but the uncertainty in the change of administration makes me mildly anxious. I am somewhat heartened this morning by John Halamka's thoughts on what may occur (see Healthcare IT in the Early Obama Administration).

The US National program is one of the most brilliant things I think the Bush administration has executed in the last eight years, and coming from me, that's a concession.

• HITSP has hundreds of organizational members, from a variety of perspectives, and a significant number volunteers contributing to the development of a realizable and rational health information network.
• The NHIN's have made significant progress in the development of the backbone for our health information.
• CCHIT has contributed greatly to improve the capabilities of healthcare IT.

These programs need to continue. They all need fine tuning, but I'd hate to see any one of them go through a great upheavals. My advice to President-elect Obama, his coming administration, and the new Congress with respect to the activities of these organizations would be the following:

1. Continue to support the work of the Office on the National Coordinator.
2. See what HITSP, CCHIT and NHIN are doing before initiating any great changes.
3. Engage with Healthcare IT leaders from those organizations before doing so.

When you compare the investment our National program to what nations elsewhere sped, it is a paltry sum. But the return on that investment is already huge. For every $1 ONC has committed to spending (some not even spent yet) on healthcare IT initiatives, states and regional initiatives have multiplied it nearly ten-fold.

The next year promises to be very interesting indeed. As Miranda said:

O, wonder! How many goodly creatures are there here!
How beauteous mankind is! O brave new world, that has such people in't!
-- Sheakspeare, The Tempest, Act V, Scene 1