Yesterday, the industry group HIMSS released their blueprint for the incoming Obama administration. Quoting the Executive Summary, the blueprint makes the following recommendations (our perspective in italics):
Invest a minimum of $25 billion in health IT to help non-governmental hospitals and physician practices adopt electronic medical records (EMRs). Additional funding should be allocated to cover EMR adoption by federal and state-owned healthcare providers, and establish health IT Action Zones. HIMSS also calls for the State Children’s Health Insurance Program (SCHIP) to be expanded to make health IT available to Medicaid and SCHIP providers of healthcare to children.
Okay, so you have now joined the auto industry looking for government hand-outs. Now why exactly does this industry believe it is any more deserving than others to receive this government largess. If we, the government (tax payer), give you this $$$ how do we know you will spend it wisely as your track record to date isn’t all that great. And by the way, did you not recently refer to yourself as a industry trade organization receiving the majority of funding from encumbent HIT vendors? Hmmm, this is beginning to smell funny.
Apply recognized standards and certified health IT products among all federally funded health programs by requiring that federal funding to assist providers and payers within these programs adopt health IT only be used for the purchase or upgrade of new health IT products that apply Healthcare Information Technology Standards Panel (HITSP) interoperability specifications and have Certification Commission for Health Information Technology (CCHIT) certification.
Time and again it has been shown that setting firm parameters around virtually any technology ultimately stifles innovation. Now, don’t get us wrong, we are all for interoperability, but HITSP & CCHIT? Why not ASTM, or NIST? Not a big fan of this approach, besides HITSP and CCHIT abound with vested interests (e.g., encumbent HIT vendors who already have a lock on the industry and big medical institutions that have huge sunk costs).
Expand Stark Exemptions and Anti-Kickback Safe Harbors for EMRs to cover additional healthcare software and related devices that apply HITSP interoperability specifications, are CCHIT-certified, and allow for better coordination of care and information sharing among related providers and their patients. In carrying-out out this recommendation, the Secretary should implement necessary measures and requirements to protect against conflict of interest and improper relationships among providers.
No problem with exemptions, big problem with HITSP and CCHIT (see above).
Codify HITSP as the National Standards Harmonization Body responsible for collaborating with the public and private sector to achieve a widely accepted and useful set of standards to enable the widespread interoperability among healthcare software applications. Adequate funding should be authorized and appropriated for HITSP from FY10 – FY14.
Don’t see a lot of value here. So where is the value? Using market-based incentives, ala CMS’s eRx program that is rolling out in ’09. Let’s leverage federal healthcare spending to encourage other changes. No, you don’t need HITSP or CCHIT to do this, just use all that fed spending (DoD, federal employees, CMS, etc.) and ask for records in CCR or CCD format to receive payment.
Codify a Senior Level Health IT Leader within the Administration to oversee a national health IT strategy.
Do we have such IT leaders in any other branch of government? No, so why here?
Authorize a Federal Advisory and Coordinating Body for Health IT. Based on the experiences of the AHIC and its Successor organization, the US Congress should authorize a federal advisory committee – operating under the Federal Advisory Committee Act – responsible for advising the Administration on health IT initiatives throughout the US and coordinating standards harmonization through collaboration with HITSP and CCHIT.
Let’s go with Daschle’s proposal instead for a board similar to the one for the Federal Reserve.
Conduct a White House Summit on Healthcare Reform through Information Technology to develop consensus and propose solutions to critical, national health IT issues within the context of the larger national healthcare reform effort.
This industry has eventitis. Do we really need another one where all the pundits that make the conference rounds today have just one more event to put in their calendars? Please, enough already.
For another view on how to spend federal largess, that is if there is any left after Wall Street and Main Street are done, Rick Peters did a fabulous post recently that deserves a full reading, including the comments. Now there is a blueprint worth reading Mr. President-elect Obama and Senator Daschle.
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