Summary: To prevent medical errors, reduce costs, improve quality, and produce greater value for health care expenditures, President Bush has called for the Department of Health and Human Services (HHS) to develop and implement a strategic plan to guide the nationwide implementation of health information technology (IT) in both the public and private health care sectors. The Departments of Defense (DOD) and Veterans Affairs (VA), along with other countries, have already taken steps to improve health care delivery and administration by implementing IT solutions. GAO was asked to provide an overview of HHS's recent efforts to develop a national health IT strategy for realizing the President's vision, and to identify lessons learned from DOD's, VA's, and other countries' experiences in implementing health IT.
The Secretary of HHS appointed the National Coordinator for Health IT in May 2004. In July 2004, the national coordinator released a framework for strategic action, which outlines four goals and 12 strategies to guide the development of a full strategic plan for national health IT adoption. The framework builds upon already-existing work in federal health IT and includes plans to identify and learn from agencies' experiences. It also describes actions to be taken by both the public and private sectors to achieve interoperability in health IT across the nation. HHS plans to address the goals and strategies of the framework with a three-phased approach over a number of years and is currently implementing phase I of the framework. However, HHS has not established milestones for the completion of phase I activities nor has it made detailed plans or set milestones for the completion of activities for phases II and III. GAO identified lessons learned from DOD and VA that could provide valuable insight to HHS as it works toward implementing a national health IT infrastructure. DOD and VA operate the largest health care delivery networks in the nation, and important lessons can be taken from their experiences in health IT. Additionally, other countries have begun initiatives to establish national health IT infrastructures. DOD, VA, Canada, Denmark, and New Zealand provided GAO with valuable lessons learned that can be applied to the United States's efforts. Among other lessons learned, they reported the need to obtain the endorsement of top leadership, define and adopt standards, address the needs of stakeholders, and deploy IT solutions in small increments and build on successes.
