3. Government is really good at building silos of information, one act of Congress at a time. Government is really bad at integrating these silos of information quickly or inexpensively. At a HIMSS analytics conference this June, one speaker said that CMS alone has multiple data warehouses, built over the years, which have great difficulty sharing information with each other.
4. HIPAA currently has a prohibition against the federal government planning or even researching a national patient identifier system. H.R. 3024 claims the Medicare smart card pilot will be compliant with HIPAA. That should be interesting to watch, particularly after the HHS lawyers get through with it.
5. Should we have a smart card for every possible use in society? That's the direction modern society is going. Library cards, brand loyalty cards, insurance cards, keys as cards – they're all getting smarter. But no one is making wallets any bigger. Or if they are, they shouldn't be. We will need flexibility, so at the consumer's discretion, they can use one smart card in multiple ways.
With all these problems, it's no wonder that "analysis paralysis" seems to be the order of the day. Now let me suggest what can be done about it.
1. We should let Rep. Gerlach and his Medicare smart card allies make their case. Similar legislation was introduced in the last Congress but didn't get anywhere. This time, let's hold a hearing. Capitol Hill holds lots of hearings about what's wrong with healthcare in this country. It's time for (another) hearing or two about the role that technology can play to solve the identity problem, the fraud problem, and the problem of Congress building one information silo after another.