HCOs advise how to build the "medical internet".

Brailer speaks and healthcare organizations listen--and respond. Brailer received more than 500 communications in response to his November 2004 request for ideas on how to design a national health information network. Here is what healthcare organizations and professionals told him.

The College of Healthcare Information Management Executives (CHIME), representing more than 900 healthcare CIOs, recommended:

* defining a comprehensive funding model and providing robust incentives for technology adoption;

* enacting unique, national identifiers for patients, caregivers and healthcare organizations;

* requiring rigorous national standards for national interoperability;

* specifying a regional implementation strategy for consistency across the nation;

* leveraging Web-based technologies and decentralized data repositories;

* removing legal restrictions to allow stronger financial incentives, collaboration and data-sharing.

The CIO Executive Council, a professional organization of more than 200 CIOs sponsored by publisher CXO Media Inc. and CIO magazine, also supported financial incentives from the federal government for keeping digital records and suggested a fee-based model tied to volume of use or type of information being accessed.

Eight of the nation's largest technology companies--often rivals--have formed the Interoperability Consortium to speed the development of the national health information network. They include IBM, Microsoft, Intel, Oracle, Accenture, Cisco, Hewlett-Packard and Computer Sciences. Submitting recommendations in a 134-page report as "one voice," they recommended that the government establish a nonprofit company with board members appointed by the Department of Health and Human Services to arbitrate technology standards.