A year ago, HHS Secretary Mike Leavitt upped the ante in the
federal effort to promote healthcare information technology by
appointing 16 members to a new federal advisory panel he called
the American Health Information Community.
Naming himself and David Brailer, then national coordinator for
health information technology, co-chairmen of the panel, the
organization has served as the focal point of the federal
governments efforts to increase the use of technology in
Since September 2005 the community hasnt provided a lot of
visible progress, though thats unsurprising given the task at
hand, industry executives say.
If people were looking for substantive, nitty-gritty
resolutions, they were looking in the wrong place, said Scott
Wallace, president and chief executive officer of the National
Alliance for Health Information Technology. This stuff is
really difficult. You can talk about it in theory and wave your
hands around, but doing it takes time. Its not simple stuff.
Members of AHIC also underscored its difficult job. Its easy
to look at the process and wonder why things arent going faster
and the fact is, this is extremely complicated, said John
Houston, director of the information services division at the
University of Pittsburgh Medical Center, as well as its privacy
officer and assistant counsel. Houston serves on two AHIC work
groupselectronic health records and on confidentiality, privacy
and securityand has been a member of the federally funded
National Committee for Vital and Health Statistics.
Houston said hes satisfied with the progress at AHIC thus far,
even though there are not yet a lot of tangible results. How
you lay out the NHIN (national health information network) is
not something that gets done in a day or even a year. It just
takes time, he said.
The community has met eight times since its founding, creating
six work groups, assigning four of them
breakthroughsshort-term projects that could be implemented in
one or two years. The breakthroughs aim to publicly demonstrate
the impact of healthcare IT. Each of the work groups have more
than a dozen members, including representatives from private
industry as well as the Defense Department, the Veterans Health
Administration, HHS and the CMS.
Part of its role so far has been to serve as a focal point.
AHIC has been great as a coordinating body and a
priority-setting body, said John Halamka, chief information
officer of CareGroup Healthcare System, Boston, and the Harvard
Medical School. Halamka also serves as chairman of the Health
Information Technology Standards Panel, a group created last
year pursuant to a $3.3 million HHS contract with the American
National Standards Institute.
Youve got to be careful because there are so many moving
parts, Halamka said. The AHIC has been good at keeping us
aligned, so theyve had a very important function.
One of AHICs next efforts will come at its next meeting Oct.
31, when the community is scheduled to receive a short list of
high-priority healthcare IT standards from the Health
Information Technology Standards Panel. Once that occurs, those
standards will be folded into the electronic health-records
certification commissions work and that will be folded into the
ambulatory-care environment, said Douglas Henley, executive vice
president of the 93,000-member American Academy of Family
Physicians and a member of the AHIC panel.
I think overall the community has been successful in promoting
as its primary goal moving toward electronic standards, thanks
to the direction, and quite frankly the pressure by Secretary
Leavitt, Henley said.
Other executives also said Leavitt has been important to AHICs
progress. I think (Leavitt) got healthcare IT on a lot of
senior leaders' agendas, Wallace said. The fact that hes been
at every AHIC meeting has given people the sense that, Wow, he
is serious about this. I think this is the first attempt to
extend ITs reach across the federal government.
You have to look at this in terms of leadership and symbolism,
that this is a major issue that people need to be focused on. I
think the inspirational piece is an important piece of it. I
think they will do substantive work. Its still nice to see it
on the secretarys agenda, Wallace said. The creation of AHIC
essentially placed Leavitt at the head of the federal health IT
effort, a role previously held by Brailer, who has since left
the Office of the National Coordinator for Health Information
Technology, but remains an adviser to Leavitt and an AHIC
co-leader. Brailer said AHICs role is critical to advancing
healthcare IT. Its a receptor site for contractors to deliver
their reports to the government, Brailer said. Whats done at
the AHIC is done in public.That gives the reports
broader exposure than if they were simply handed over to an HHS
officer. Also, AHIC brings together leaders in and out of
government to review and critique the contractors reports as
well as the deliberations and recommendations of its own work
groups, Brailer said. How else would we have that dialogue?
Its active, hands-on negotiation.
At meetings, Leavitt also reminds AHIC members that time is
precious, often counting down the days remaining on the groups
two-year mandate. Let me underscore the word urgency, Leavitt
said at the Sept. 12 meeting. We dont have enough time to get
Houston said hes not put off by Leavitts pressure. My fear is
if you dont really try to drive it by imposing deadlines, you
can get bogged down in what almost becomes academic exercises.
This needs to be pushed. When you push people, you force them to
make hard decisions. Having been on NCVHS (the National
Committee for Vital and Health Statistics) for almost four years
now, you can listen to a lot of perspectives for a long time and
none of them are wrong. Youve got to at some point sit down and
say, This is what we have to focus on. It forces people to
say, OK, weve got to get answers.
In August, Leavitt announced he would ask the CEOs of the 100
largest U.S. employers to join the federal governments effort
in specifying that interoperable IT be used by the providers
that employers contract with for their workers
The goal was to get more formal commitment to the process, said
Kevin Hutchinson, CEO of SureScripts, a for-profit company set
up by two leading pharmacy trade associations to provide
software and infrastructure for e-prescribing connectivity.
Hutchinson also serves on AHIC and on its consumer-empowerment
They basically are going to put their money where their mouth
is, Hutchinson said.
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