National health networking: It takes a government

Last week, the federal government handed out $22.5 million in contracts to nine health information exchanges, whose job will now be to run trial implementations of the National Health Information Network. Another dull government program announcement? Not necessarily. We may be looking at something small here, as national projects go, but it's the start of something big.

As readers know, I'm not a huge fan [1] of most current HIE/RHIO efforts, largely because I don't see them as sustainable. But as a little network known as "the Internet" reminds us, the government can slowly, stubbornly breathe life into networking projects that didn't have a leg to stand on before. So the fact that the NHIN has creeping along [2]for years now doesn't mean the project is doomed by any means.

Ok, I admit that compared with the legal, strategic and financial issues involved in robust clinical data sharing efforts, building out the Internet was a carefree exercise. Nobody needed to be worried about sharing high volumes of mission-critical data with competitors every day, consumers weren't facing exposure of their most personal conditions to the broader world, and you didn't have to invest in a $500K+ enterprise system to get involved.

Not only that, while the development of IP networking standards wasn't trivial, the complexities involved in encoding and sharing clinical data put them to shame. Look at the Tower-of-Babel-like number of standards-development efforts out there. I don't have to implement them and it gives me a headache to contemplate it.

Still, if any entity can make national health data sharing a reality, it's the feds. Just imagine the grip of death the IRS puts on an errant taxpayer--then envision what can happen when similar levels of tenacity, thoroughness and institutional resources are turned towards the clinical data sharing problem.

Sure, it's still a long (maybe very long) term project, and there's probably obstacles ahead that will daunt even a massive agency like HHS. But even if you're buried in day to day enterprise IT problems, I would keep an eye on this project.  That way, when you're called on to get involved, you'll know what to do.-Anne [3]