David Blumenthal, M.D., has left government service to return to Harvard, having spent a whirlwind two years as national coordinator for health information technology. I have mixed feelings about his performance, but that doesn't temper the respect I have for the overall job he did.

On the negative side, he wasn't particularly media-friendly. When we talked it wasn't for long and he stuck to the script as much as possible. He never fixed the glaring lack of representation of physician practices and community hospitals on the HIT Policy and Standards advisory committees, which have considerable influence over the meaningful use rules and design of the emerging nationwide health information network.

And he didn't start the meaningful use program with the strong privacy and security protections promised to consumers being asked to support the transition to electronic health records and electronic exchange of all that data. Two years after HITECH was enacted there are no final privacy/security rules, providers don't have to encrypt data AND they get to decide whether or not to report data breaches. That was and remains inexcusable.

But... look at the body of work that Blumenthal oversaw in just two years. Flush with $2 billion in discretionary funds from the stimulus law, he ramped up ONC staffing with a lot of competent, committed professionals. The office developed, funded and oversaw the launch of programs to build statewide health information exchanges, provide technical assistance to primary care physicians and rural/critical access hospitals automating patient records, train tens of thousands of new health I.T. professionals, and demonstrate the promise of health I.T. through 17 Beacon Communities.

When the proposed meaningful use rule came out there was a chorus of protest that the criteria was unrealistic. There was disbelief that so much was being demanded of the industry in so short a time period. Blumenthal believed the bar should be high for meaningful use and stuck to his guns, but listened at the same time. The final Stage 1 rule still makes meaningful use a big challenge, but it's doable.

The HITECH Act was intended to vastly accelerate provider acceptance and adoption of I.T. necessary to support comprehensive health care reform. The reform provisions now are being implemented. Blumenthal's task was to set the I.T. table--really fast--for those provisions, and he did it. The tipping point has come and gone--providers might not like it but now accept that EHRs and HIE are the future.

Most importantly, when asked to serve in the new administration he did so, and that has to count for something. So, thank you, Dr. Blumenthal, for your public service and best wishes.

Joe Goedert is News Editor at Health Data Management


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