The search for a new point person to head the national effort to foster the use of electronic health records is being stymied on several fronts, according to health care executives.
Several users noted this week that the three-month search has been hurt because of its timing -- coming near the end of the Bush administration -- and the reluctance of some candidates to abandon their own fledgling IT projects.
A U.S. Department of Health and Human Services spokeswoman said this week that the search to replace David Brailer -- who resigned as national coordinator for health information on April 20 -- is still under way but added that she has "no idea" of its status.
The search is being led by President Bush and HHS Secretary Mike Leavitt.
J. David Liss, vice president of government relations and strategic initiatives at New York-Presbyterian Healthcare System, predicted continued delays because of difficulties finding capable candidates "in the closing days of an administration and in a time of budget shortfalls."
Liss suggested that the delay likely won't affect HHS and private-sector efforts to promote the use of electronic health records and create an infrastructure to exchange those records. "That horse is out of the barn," Liss said. "It may run fast or walk slow, but it will cross the finish line."
J. Marc Overhage, CEO and president of Indianapolis- based Indiana Health Information Exchange Inc., added that some people may be reluctant to move to Washington for a presidential appointment that will likely end at the close of the current term.
But he also expects that work on the effort will continue unhampered for the next six to 12 months without a new coordinator.
"I really believe a lot of this work takes time to complete. We may actually come out ahead by having time for processes to work through and for care-delivery organizations to learn more," Overhage said.
Mark Frisse, a professor of biomedical informatics at Vanderbilt University in Nashville, noted that the search may be hampered because qualified candidates are immersed in their own health IT projects.
"I and most of my colleagues are quite engrossed in functioning, real-world projects where we are only beginning to see the impact," said Frisse, who is developing a regional health information organization in Tennessee. "Given the relative slow but positive pace of the federal government, the enormous activity in the states and the local opportunities for immediate change of national significance, one should not be surprised if anyone involved in such local initiatives is torn between moving forward locally and federal service."
Nonetheless, he added, there are pressing issues that require a coordinator, including communicating a vision that fosters public trust in health IT, coordinating efforts among federal agencies to adopt health IT and managing contracts awarded by HHS for health IT prototypes.
Scott Tiazkun, an analyst at IDC in Framingham, Mass., said that a new national coordinator would likely continue on the job under a new president.
"When Bush leaves office, I assume that the person who has that job will not leave," he said. "This is one of those positions that people do not take a political stance on." Rather, the president will tap "someone who is competent and has a vision."
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