White House/VA Conference
Emerging Technologies in Support of the New Freedom Initiative:
Promoting Opportunities for People with Disabilities October 13-14, 2004

Drawing of White House and Logos of the Dept of Veterans Affairs  and the Executive Office of the President

ďA tremendous effort is underway in the National Institutes of Health to improve and accelerate clinical trial discoveries and take those findings directly into practice and translate them so that doctors are able to access medical evidence and know what treatments are most relevant to patients.ĒóDr. David J. Brailer


Thank you, Mr. Secretary, Secretary Mineta, Dr. Marburger.

Ladies and gentlemen, it’s a privilege to be here with you today. I applaud your leadership, and I am very happy to be part of this.

A year ago, I was actually in a research center in San Francisco and was asked to participate in a report called “The Emergence of the Bionic Man.” And I thought: this is very interesting. This report was about the profound convergence of implantable devices and other assistive technologies that incorporated information technology and wireless transmission.

What we discovered was a future that is not far out. Frankly, many of you know much more than I about this convergence and the ability of these technologies to change lives. Since I have come to the government this past year, I have seen it already happening in the Veterans Administration (VA) and in other parts of the government, These technologies have already improved healthcare and transformed lives, yet I think that we are at a position where these technologies can clearly bring us to another era.

Photo of David J. Brailer, MD, PhD

Dr. Brailer was appointed the first National Health Information Technology Coordinator by Health and Human Services Secretary Tommy Thompson on May 6, 2004. Dr. Brailer is one of the nationís foremost authorities on clinical data sharing, local health information exchanges, and the use of peer-to-peer technologies in health care. Previous to his appointment, he was a Senior Fellow at the Health Technology Center in San Francisco, a nonprofit research and education organization that provides strategic information and resources to healthcare organizations about the future impact of technology in health care delivery. Dr. Brailer recently completed 10 years as Chairman and CEO of CareScience, Inc., (NASDAQ: CARE), a leading provider of care management services and Internet-based solutions that help reduce medical errors and improve physician and hospital-based performance. Dr. Brailer holds doctoral degrees in both medicine and economics.

I want to step back, though, because the other speakers have talked about this very clearly. To me, what underlies this—and this was the purpose of the President’s April 27 Executive Order to bring about the Health Information Technology Strategic Plan—is the need to think about how we use technologies today and in the future to enable a market for healthcare services where consumers have better choice, easier mobility, and the capacity for taking more direct control over their healthcare consumption, and therefore over a major part of their lives.

This strategic framework, which Dr. Beato very eloquently summarized earlier this morning, lays out what we believe to be the key elements that are needed to bring healthcare to the point where we not only can take advantage of the great advances we’ve heard about today, but also set a basis for moving forward.

We have the ability to make health information a key aspect of the therapies that happen daily between doctors and patients. Today, there are two elements that I’d like to present to you, and challenge you to think about during the discussions.

The first is the concept of telemedicine. We’ve made great strides in bringing advances that make all of us more capable, as well as making people who live with disabilities more mobile and more independent. Telemedicine has also brought healthcare to peoples’ homes and to the workplace.

Many aspects of care delivery today don’t require the physical proximity of a doctor and a consumer, but some things clearly do. We will continue to build on the work in the Department of Commerce and the Department of Veterans’ Affairs today to develop the capacity to make telemedicine the norm in healthcare.

This is not just true of people living with disabilities, who face challenges getting into healthcare facilities. It is true for everyone who consumes heathcare due to many inherent challenges with getting to the point of care.

To advance this goal, we are developing the design for a Health Information Network. You no doubt have heard about this. The network’s goal is very simply to be able to move information securely between doctors, hospitals, laboratories, and pharmacies so that when any person moves through the healthcare system, their information will move with them, if they choose.

I encourage you to give us guidance in thinking about what is it that telemedicine should do. What questions should it address? How can it move forward? Because we’re poised to be able to do this.

Second, we must address the question of evidence. You’ve heard some discussion this morning about prevention. One of the great capabilities of technologies that collect information from the home, from the point of care, from the pharmacy, and from the laboratory, is the ability to help us understand the root causes of illness or injury, as well as the right medical responses to the condition, how long it takes for certain treatments to be delivered, how much they vary, and whether or not those variations matter.

If we don’t design this data collection into the kinds of systems that are being built over the next decade as a result of the President’s Executive Order, we won’t be able to address the questions that will empirically advance the ability to deliver new treatments or new preventative mechanisms to deliver new treatments or new preventative mechanisms. We’re doing this with clinical trials today. A tremendous effort is underway in the National Institutes of Health to improve and accelerate clinical trial discoveries so that we can take those findings directly into practice and translate them so that doctors are able to access medical evidence and know what treatments are most relevant to patients they serve. This is something that goes beyond the formal clinical trial. It encourages and builds upon the empirical experience of natural experimentation. To capture these experiences and outcomes over time is incredibly data-intensive.

But we need your guidance today. To realize our vision for a healthcare system that is truly consumer-centric, we need very much to know what you think are the key questions and considerations we should be addressing in this particular area, because it is a still-emerging, cutting-edge field.

Thank you very much for the opportunity to be here. I am very proud to be part of this, but we have a long way to go. I encourage your deliberations today, and I look forward to talking with you more about information technology in healthcare.



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