HHS awarded $18.6 million in contracts to design and implement prototype networks for electronic health records. The choice of large corporations for what is a relatively small contract raised red flags with some industry players that the systems ultimately adopted by HHS won't be as open as desired.
Chosen were Accenture, New York; Computer Sciences Corp., El Segundo, Calif.; IBM Corp., White Plains, N.Y.; and Northrop Grumman Corp., Los Angeles.
The four companies--in conjunction with other IT companies and health systems, have been charged with creating separate beta versions of an electronic health information exchange--one that would allow patients and doctors to electronically access critical information stored on patient records. Their systems will be tested in eight states: California, Indiana, Kentucky, Massachusetts, North Carolina, Ohio, Tennessee and West Virginia.
After one year, HHS, its National Health IT Coordinator David Brailer and the American Health Information Community then will "take the best of the best" ideas from each group to implement into a viable product designed to deliver critical heath information online. The product also would keep President Bush's promise to take patient records electronic over the next 10 years.
"There will be a process (where) the elements of the prototypes ... of the highest value will be brought together in a next-step process," Brailer said during a Nov. 10 conference call.
While lauded by many in and outside of healthcare circles, Brailer and his all-tech, all-the-time policy have picked up some critics over the past six months. When Brailer introduced three HHS contract winners Oct. 6, patient-privacy advocates grumbled that the IT czar's picks would weaken privacy protections, while others wondered if the process was tainted (Oct. 17, p. 14).
Even those who solidly back Brailer's plan have raised questions. Scott Wallace, president and chief executive officer at the National Alliance for Health Information Technology, said that a number of bidders who were not selected for the contracts would nevertheless move forward with their own projects. Wallace also said that the original request for proposals called for more of a mix between big and small companies--something not noticeably recognizable with the four named last week.
Brailer said that his office and AHIC want to keep the process as transparent as possible and would listen to the groups not selected through the RFP process.
"It's important that they do that," Wallace said. "In picking such big-name vendors, there is a real risk of the perception that this network is going to be proprietary and they can't have that. This network has to be open."
The contracts are the last in a series of RFPs that HHS issued more than a year ago. HHS previously awarded contracts to create a set of standards for interoperable systems, for a certification process for health IT products and for the development of a group to analyze individual state privacy laws.