The bill does address the data standards piece. It asks the to establish a standards committee. And, of course, we already have the , which has been working for three or four years now to harmonize standards. It is a challenge for health care. There's continued progress to be made in that realm. We're not there yet.

Kennedy: Should we create a centralized data base from which all patient information is shared, or is it more about standardizing the interconnectivity to the various databases? It's some of both. Standards help in allowing data in system B to get into system A, but let's not forget there have been interface engines around for years. So it makes the work easier to do, but it's not a panacea in and of itself.

The more important questions is, what is your data architecture? What we'd like to see is an approach where the patient's clinical status can be represented electronically, not just what the primary care doctor is doing or specialist is doing, but an integrated view of the patient. Once you have that single representation of that patient electronically, then you can begin to run rules off that single electronic representation. That's where we'll see real value. Instead of taking 17 years for clinical research to make it's way into practices, we'll be able to create rules where it may become 17 days. It's that single representation of the patient and applicability of clinical rules to the data in real time that offers us the foundation to deliver on what people hope health IT can do.

Should the EHRs be controlled by the patient or the health-care organization?

Kennedy: We think in order for this to be successful it needs to be patient driven, patient controlled. The reason is that if you look at what's costing so much money in health care today, it's chronic disease management. Chronic diseases are not something you go to the doctor and get fixed. They're something you manage over time. To deploy tools that don't have a patient-centric approach and expect, by automating the physician's office alone, to see substantial improvements in the cost of care really isn't that rational.