10 IT agenda items for the first US CIO

Obama's appointment of Vivek Kundra marks an important first step for rectifying the nation's concerns about IT

Agenda item No. 6: Tax breaks for rural broadband last-mile carriers

It's no secret that broadband access to much of rural America is spotty at best. In fact, there are many not-so-rural areas that are grossly underserved. If we're to hold ourselves up as leaders in the Digital Age, we need to make broadband more widely available to those who don't live in metropolitan areas.

The US government has tried rural broadband initiatives before. It even created a fund that ISPs could draw from to extend broadband access. Carriers such as Comcast and Verizon took their share and frittered the subsidies away without making significant strides toward connecting the unconnected.

While it's not generally a good idea to throw good money after bad, a performance-based incentive program might be the place to start. Here, tax breaks could provide a spark. Under such a program, every previously unserved household brought into the broadband fold would result in a small tax break for the carrier responsible. In order to increase competition and reduce the de facto monopolies that exist in underserved areas, this incentive could be extended to any last-mile carrier that brings service into an area that currently offers only one other existing broadband option.

Agenda item No. 7: Codify national standards for electronic medical records

In this day and age, it shouldn't be a challenge for one hospital or clinic to securely access a patient's medical records, wherever they may be. In the paper era, this meant couriers, copiers, and lots of dead trees. These days, all it should require is sufficient authorization, encryption, and perhaps a proxy for auditing purposes.

Currently, many patients' medical records are stored electronically in a database run by whatever EMR software your clinic or hospital is using. Access to those records from outside entities is all but impossible in most cases, requiring the records to be printed out and snail-mailed to another location. Since these records already exist in digital form, there should be a better way to safely and quickly transmit that information to another health care provider, especially in an emergency.

If the US government set up a central proxy -- not a repository -- for EMR transactions, it could effectively keep accurate logs on the transmission of medical records from facility to facility, conform to HIPAA standards, and still enable medical records to easily move where they're needed.

After this article was written, but before publication, Obama introduced a somewhat amorphous plan related to electronic medical records, but the particulars of this program aren't readily available and are likely still in the development phase.

Such an agenda would require the cooperation of all EMR software developers, but that's what standards are for. Come up with a central XML-based standard for the records with the help of those companies, and let them transition their products to work with the central proxy. It'll take time, but the result will be worth it -- especially if you've just had a car accident in another state.

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