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recognition that having an effective IT architecture will enable us to get to the goals that have been put out in the presidents executive order for accelerating the rate of implementation of electronic health records to provide better health outcomes for citizens.

We have been leading the Federal Health Architecture for a year now. It is driven by the Office of Management and Budget and HHS. They recognize the need to have federal agencies better collaborate towards better data sharing and interoperability. Those are the two goals were trying to achieve with the architecture: the ability to move information more efficiently and to have valued-added information in the hands of decision makers.

We are working on the health information standards and looking for ways to implement various steps to support and encourage health IT for public health.

In terms of private health care delivery systems, in order to do that, we need a consistent framework that will allow us to better communicate across the federal landscape. This will hopefully encourage the private sector to line up with the business processes, data standards and technical standards for interoperability.

WTN: What lead to the creation of the FHA?

Heuer: It was initially about public health monitoring, but we really pushed back a bit and said that this is broader than that and what we really need to do is better encourage better information sharing across the entire health care system. Not only public health surveillance, but in terms of patient care delivery and terms of food safety, in terms of bio-surveillance, as well as research and development, research of new drugs, research of clinical trials. What is effective in terms of care? We wanted to look at different ways of treating patients. We think that there are better ways of allowing information sharing that can create a more collaborate environment which can get to solutions on a more expedient basis.

WTN: What form will the FHA take?

Heuer: The Federal Health Architecture is a partnership, where HHS is the sponsoring agency, along with six other agencies that have a big footprint in terms of health. These include Veterans Affairs, Dept. of Defense, Environmental Protection Agency and the Dept of Energy. HHS does the most in terms of health care delivery and the focus on health.

WTN: How does the FHA tie in with other E-Gov. initiatives?

Heuer: The Office of Management and Budget several years ago came out with the 24 E-Government Quicksilver initiatives in order to devise a citizen-centered strategy for E-government. What we are doing now is going through five lines of business focuses and FHA is one of those lines of business initiatives. The OMB is encouraging federal agencies to work together to come up with solutions that will allow for better sharing of service delivery, information and to be more citizen centric. We want to look at the entire business process and not just an IT solution. We want to have a collaborative environment that doesnt end at the federal agency and is cooperative with the private sector. This will be driven by a business perspective rather than a technology focus with the goal to improve efficiency, reduce taxpayer burden and improve service delivery.

WTN: How will this impact the private sector?

Heuer: If we put a stake in the ground through the Federal Health Architecture, by having standards for data sharing and better interoperability, then the private sector has some certainty about how we are doing things.

I imagine this will create a market incentive opportunity for private-sector software companies to align the way they are creating data elements to line up with the federal side.

That will encourage more consistency and the ability to share information more efficiently.

WTN: What is Dr. Brailers new role at HHS?

Heuer: Dr Brailer will be responsible for both FHA and the National Healthcare Information Infrastructure. These are both elements of what he is responsible for in terms of delivering on the executive order. Over the next two months he is working on a strategic plan and principals to make sure we have a collaborative environment.

We want to have information that we can make available to the private sector and providers so they can make better decisions.

Once we have this alignment, there is a tremendous benefit where we can be moving information more quickly in terms of information flow up to federal agencies and back down to providers to help them understand trends of how diseases are presenting themselves in their local communities. If there are situations, such as SARS, we can get notices out earlier and on a more informed network. This is more than a one-way flow of information up to the federal government that has a great deal of benefit in facilitating the movement of information that will help them make better decisions.

The total 2008 budget for federal health care, administered by the U.S. Department of Health and Human Services, would be nearly $700 billion for the fiscal year that begins Oct. 1, an increase of more than $28 billion over 2007. Medicare makes up 55.4 percent of the HHS budget, while Medicaid accounts for 29 percent.

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