Q & A – Federal Health Architecture: An Interview with Kathleen Heuer


July / September 2004

Q & A

Federal Health Architecture: An Interview with Kathleen Heuer

Kathleen Heuer is the deputy assistant secretary, Budget, Technology and Finance, at the Department of Health and Human Services (HHS). She discussed the Federal Health Architecture at the Digital Healthcare Conference sponsored by the Wisconsin Technology Network in June 2004. This interview first appeared on the Wisconsin Technology Network’s Web site (www.wistechnology.com) on June 14, 2004.

MK: What is the Federal Health Architecture, and how is it gaining more attention in Washington?

Kathy Heuer:Secretary Thompson held a Health IT Summit on May 6, and several key stakeholders called for an architecture to assist in health IT implementation. The Federal Health Architecture (FHA) is a methodology for developing health information interoperability standards and an initiative that will explore ways to implement and support health IT for public health. I think there is recognition that having an effective IT architecture will enable us to get to the goals that have been put out in the president’s 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 we’re 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 healthcare 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.

MK: What led to the creation of the FHA?

Heuer:It was initially about public health monitoring, but we pushed back a bit and said that this is broader than that. What we really need to do is better encourage information sharing across the entire healthcare system. Not only public health surveillance, but in terms of patient care delivery and in terms of food safety, in terms of bio-surveillance, as well as research and development, research of new drugs, and 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 and get to solutions on a more expedient basis.

MK: 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, Department of Defense, Environmental Protection Agency, and the Department of Energy. HHS does the most in terms of healthcare delivery, and the focus on health.

MK: How does the FHA tie in with other E-Government initiatives?

Heuer:The Office of Management and Budget several years ago came out with 24 E-Government “Quicksilver” initiatives in order to devise a citizen-centered strategy for E-Government. With E-Government, President Bush wants to use improved Internet-based technology to make it easy for citizens and businesses to interact with the government, save taxpayer dollars, and streamline citizen-to-government communications.

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 doesn’t 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.

MK: How will this impact the private sector?

Heuer:If we put a stake in the ground with 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.

MK: What is David Brailer’s new role at HHS?

Heuer:As national health information technology coordinator, 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.

Mike Klein is editorial director of the Wisconsin Technology Network in Madison, Wisconsin. He may be reached at mike@wistechnology.com.