But they stressed that whoever replaces David Brailer, who resigned as national coordinator for health information technology late last month, must quickly show measurable progress in the e-health arena. The next coordinator must also foster closer collaboration between the government and doctors, users said.

President Bush appointed Brailer in May 2004 to help lead a national effort to replace paper-based health records with electronic medical records. Health care IT execs said Brailer was a high-profile advocate of EMRs and of creating the standards and infrastructure needed to exchange them.

John Wade, CIO at Saint Luke's Health System Inc. in Kansas City, Mo., said Brailer's departure nonetheless could speed the move toward a national health information network, prompting a shift from planning to action.

Brailer did a "spectacular job" of building awareness among Congress and the public regarding how much work is needed to create an EMR network, Wade said. "He's the one who had to be the standards advocate while at the same time navigating the political issues to gain and sustain momentum," Wade said.

Mark Frisse, a professor of biomedical informatics at Vanderbilt University in Nashville, said Brailer brought a human face to what were intangible issues. Through that effort, he said, "the health care IT horse is out of the barn, and sufficient consensus exists that rapid acceleration is possible."