The Federal Role in the Health Information Infrastructure: A Debate of the Pros and Cons of Government Intervention
- Affiliations of the authors: Stanford University School of Medicine, Stanford, CA (EHS); Harvard Medical School, Center for Clinical Computing, Boston, MA (HLB); IBM Government Programs,Washington, DC (CGC); University of California at San Diego, La Jolla, CA (DRM); and KnowMed Systems, Berkeley, CA (DWS)
- Correspondence: Edward H. Shortliffe, MD, PhD, Professor of Medicine and of Computer Science, Associate Dean for Information Resource and Technology, Stanford University School of Medicine, Stanford, CA 94305.
Abstract
Some observers feel that the federal government should play a more active leadership role in educating the medical community and in coordinating and encouraging a more rapid and effective implementation of clinically relevant applications of wide-area networking. Other people argue that the private sector is recognizing the importance of these issues and will, when the market demands it, adopt and enhance the telecommunications systems that are needed to produce effective uses of the National Information Infrastructure (NII) by the healthcare community. This debate identifies five areas for possible government involvement: convening groups for the development of standards; providing funding for research and development; ensuring the equitable distribution of resources, particularly to places and people considered by private enterprise to provide low opportunities for profit; protecting rights of privacy, intellectual property, and security; and overcoming the jurisdictional barriers to cooperation, particularly when states offer conflicting regulations. Arguments against government involvement include the likely emergence of an adequate infrastructure under free market forces, the often stifling effect of regulation, and the need to avoid a common-and-control mentality in an infrastructure that is best promoted collaboratively.
