The federal government awarded contracts yesterday to four consortiums that are building electronic health systems in 12 regions across the country, which are intended to serve as models for the nation.
The contracts by the Department of Health and Human Services are meant to accelerate the use of modern computer technology in health care. The contracts totaling $18.6 million are a fraction of the investment that the four groups - led by Accenture, the Computer Sciences Corporation, I.B.M. and Northrop Grumman - will invest in the regions.
The government's role is to set goals and require that companies link doctors' offices, clinics and hospitals in computer networks using open data standards so information can be easily shared. But the details of how to achieve the objectives are being left to the private sector.
"This is a hands-off government approach," said Dr. David J. Brailer, the Bush administration's coordinator for health information technology. "We're not operating these networks, and we're not procuring them."
Yet the competition for the four contracts was fierce because the winners may have an early lead in the market for digital patient records and health networks to connect physicians, clinics and hospitals. More than 70 corporate groups sought the contracts.
Investment in information technology is expected to grow rapidly in a drive to improve quality and curb rising costs in health care, which accounts for 15 percent of the nation's economic output.
In the dozen pilot programs, the companies are required to create personal digital health records and provide physicians with affordable online access to patient records, diagnostic information and billing. Such electronic networks are also intended to help in monitoring and responding to health emergencies like epidemics or bioterrorist attacks.
Each of the four corporate groups has three regions in which it must develop local health networks over the next year. Each can use different technologies, as long as one local network can pass patient and other health information back and forth to other local networks.
These pilot projects are seen as steps toward a nationwide health information network. The approach championed by the Bush administration is conceptually much like automated teller networks at banks; the networks are somewhat different, but they connect and share information so customers can handle transactions across the country.
And the American plan for moving to electronic health records is less directed by the government than in other countries, like Britain, where the National Health Service is financing the national network.
"We want to see competing networks," Dr. Brailer said. "There won't be one national health network. We're not doing this like Britain."
The 12 regions for the pilot projects include both urban and rural areas, from Cleveland to eastern Kentucky. Dr. Brailer hopes that what is learned in the pilot projects will guide further investment over the next several years. "We want to stimulate a lot of capital investment," he said.
