Add one more outfit to the dozen or more government and private sector organizations busily planning for the brave new age of interconnected healthcare information technology systems.
The 11-member Commission on Systemic Interoperability, which met officially for the first time earlier this month, was created by the Medicare Modernization Act of 2003.
The commissioners, five of whom are physicians, were appointed by congressional leaders of both parties and by President Bush. The purpose of the CSI, led by Scott Wallace, president and chief executive officer of the Chicago-based National Alliance for Health Information Technology, is to advise Congress and the president on how to create a world in which healthcare information flows freely between patients, physicians, hospitals and other care providers.
But that mission could have the commissioners plowing the same field owned by David Brailer, M.D., appointed by Bush in April as head of the Office of the National Coordinator for Heath Information Technology, an arm of HHS.
That could create a sticky situation, since the CSI has been directed by Congress not to duplicate the efforts of other government or private-sector organizations. In addition, under the MMA, the commission is to report its findings, including a timeline and its recommended priorities, by the end of October, giving it very little time to work.
"To some extent, they (the commissioners) are trying to answer the same question that Dr. Brailer asked," conceded Mark Leavitt, the chief medical officer of the Healthcare Information and Management Systems Society, who joined Brailer in appearing before the commission at its first meeting Jan. 10.
There are important differences between the commission and Brailer's office, however, including who they work for and when they are supposed to complete their work.
"Dr. Brailer's office is an executive branch office, and the commission was set up by Congress," Leavitt said. The Office of the National Coordinator for Heath Information Technology, which was created by a Bush executive order in April, was specifically instructed to "not assume or rely upon additional federal resources or spending to accomplish adoption of interoperable health information technology . . ."
"We don't have that restriction," Wallace said. "We can look at a federal role if the commissioners deem that necessary." Another difference, Wallace said, is that the commission can hold public hearings while Brailer's office must rely on a more cumbersome method to gain input, a formal request for information.
In November, Brailer's office issued an RFI to get public input on how best to create a national health information network, or what Brailer calls the "medical Internet." The office received more than 500 responses. Brailer will offer a run-down of those submissions to the CSI, and his office will work with CSI, albeit separately, according to a to Brailer aide.
"We had a tremendous first meeting," said Lori Evans, a senior advisor to Brailer who attended the commission's inaugural meeting. "The spirit of the discussion was that they wanted to be complementary. They haven't decided what they're actually going to home in on, but I don't think anyone is worried that they're going to be on track with what we've set forth."
The Chicago-based HIMSS, a trade association for healthcare information technology users and vendors, is keenly interested in the commission's work and direction, Leavitt said.
"The issue is interoperability is not yet fully defined," Leavitt said. "One of the hopes is that they'll help define that."