In early 2004, health IT became a national priority with President George W. Bush adopting it as a political cause. Although some progress has been made since then, the federal government is still in the very earliest stages of unraveling how to create a national health information system.

The aftermath of Hurricane Katrina and the medical records access needs of millions of displaced people have underscored and made more urgent the need for a functioning electronic medical record exchange.

Over the next few years, more small steps can be expected, but the question remains whether as a nation we will reach the goal of a functioning electronic medical record system by the middle of the next decade.

"The government is certainly leading in the creation of hype," says Gartner research director Wes Rishel. "There's a huge amount of attention to the issue, but the benefits are overblown and there's little understanding."

Rishel expects that this will lead to eventual disillusionment with health IT in a few more years, much as the Internet frenzy imploded after initially garnering such intense interest.

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But eventually, he asserts, as with the Internet, disappointment will circle back to deeper understanding and productivity based upon early successes.

But in this "hype cycle," as it is termed in Gartner consulting lingo, health IT and a national health information network are still at the very earliest stages.

This year has seen a few small steps in the maturation of health IT. Some regional networks, such as those in Tennessee and Indiana, have been able to demonstrate some technological, organizational and fiscal successes.

Also at the beginning of the year, the Commission on Systemic Interoperability convened for the first time.

The commission, created by the Medicare Modernization Act, released a report at the end of this year that outlined a strategy toward creating a health information network.

These recommendations are expected to shape federal government action on the creation of a national health information network over the next few years.

Its three areas of focus were adoption, interoperability and connectivity. A continuing concern on the adoption front is the lack of funding for the implementation of expensive health IT initiatives.

The report concluded, "The Department of Health and Human Services should implement, or seek authorization from Congress as necessary to implement, financial and other incentives for participation in a standards-based healthcare information network."

Health care providers, medical institutions, purchasers and health plans are all described as in need of financial incentives to put these systems in place.

Additionally, it calls for regulatory reform that would help to clarify existing laws that currently make the activities inherent in exchanging this type of medical information legally questionable.

Product certification and a uniform set of data standards are the leading concerns on the interoperability front.

Next year is likely to see some improvements on this issue. Early in 2006, the Certification Commission for Healthcare Information Technology, a public-private alliance initiated by the Department of Health and Human Services last year, is set to publish its first criteria.

Click here to read more about the government's efforts to boost health care IT.

"We're deliberately setting the bar where a lot of good systems can pass in 2006 and raising the level of challenge in future years," says Rishel, a commissioner. "Vendors need to recognize that we're a credible organization."

Another early step toward interoperability was the recent awarding of contracts exploring the necessary technology by the Department of Health and Human Services to private sector vendors, including IBM, Accenture, and Northrop Grumman.

Seven contracts, totaling almost $35 million, were awarded this fall for the exploration of a range of issues including privacy, security and certification compliance.

Four of these are dedicated to creating standards-based network prototypes by the end of 2006.

"These prototypes are the key to information portability for American consumers and are a major step in our national effort to modernize health care delivery," said David Brailer, national coordinator for health information technology. "This is a critical piece of moving health IT from hope to reality."