Brailer also outlined how RHIOs might fit into the government's efforts to build a national health information network to securely exchange patient data among hospitals, laboratories, pharmacies and physicians.

Brailer said he envisions the network evolving to provide a set of tools and services that doctors and hospitals could use to help them exchange data nationally or as a network that RHIOs could tie into themselves. Brailer's Office of the National Coordinator for Health Information Technology (ONC) does not now have plans to regulate the RHIOs, Brailer said. But he noted that if his office fails to move the market toward President Bush's goal of every American having an EHR by 2014, that regulations could come into play.

"If it turns out we can't get traction ? there is a group of people who will bring mandates forward," he said. "We are beyond the point where this is optional. The clock is ticking."

Brailer also described plans for the ONC to seek US$116 million in fiscal 2007, almost twice its 2006 budget of $61 million.

According to the ONC, there are about 66 RHIOs in the U.S. that are either in the planning stages or have begun to share patient data electronically. In addition, 30 states have introduced or passed legislation that supports the statewide adoption of health-related IT.