David Blumenthal, MD, who leads the government's effort to transform the nation's healthcare system from paper to digital, is urging the industry to break down barriers to health data exchange.

To ensure the best patient care, he said, information exchange must reach every nook and cranny of the healthcare system.

In an e-mail sent Thursday – the third in a series – Blumenthal outlines the provisions of the HITECH Act that addresses barriers to exchange.

Blumenthal's two previous e-mails, on Aug. 20 and Oct. 1, focused on how electronic health record systems could transform today's "antiquated paper-based system" and on the term "meaningful use." The final definition of meaningful use is expected in December.

The next e-mail is likely to address privacy and security issue, he said.

The full text of the letter appears below.

November 12, 2009

The HITECH Foundation for Information Exchange

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

As the many activities mandated by the HITECH Act move forward, I want to take a moment to share my vision of the overarching goal and some of its implications.  Our goal, above all else, is to make care better for patients, and to make it patient-centered. Information policy and health IT policy should serve that goal.

A key premise: Information should follow the patient, and artificial obstacles – technical, business related, bureaucratic – should not get in the way. As a doctor, I have many times wanted access to data that I knew were buried in the computers or paper records of another health system across town. Neither my care nor my patients were well served in those instances. That is what we must get beyond. That is the goal we will pursue, and it will inform all our policy choices now and going forward. This means that information exchange must cross institutional and business boundaries. Because that is what patients need.

Exchange within business groups will not be sufficient – the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies' vital needs.

If we are to reap the benefit of information exchange, Americans must also be assured that the most advanced technology and proven business practices will be employed to secure the privacy and security of their personal health information, both within and across electronic systems, and that persons and organizations who hold personal health data are trustworthy custodians of the information. We must have comprehensive, clear and sustainable policies that strengthen existing protections, fill gaps as they emerge, fortify new opportunities for patients' access to and control of their information and align with evolving technologies. I will devote a separate letter to this critical issue and the many activities mandated by the HITECH Act that we are developing.

On the question of exchange, however, the HITECH Act is pretty specific about eliminating inappropriate barriers.

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