At Tuesday's daylong meeting of his American Health Information Community advisory panel, HHS Secretary Mike Leavitt pushed for the development of self-sustaining health information networks, and noted how the chances of succeeding will diminish if it's not done within the next two years because, inevitably, "There will be a break in momentum" with the changing of presidential administrations.
Although federal funds could be used for seed money, Leavitt said there need to be models that can continue on after the initial money gets spent, and he advocated a "create, fund and spin-out" model.
Data-mining operations are often mentioned as source of self-sustaining funding, but AHIC Personalized Healthcare Workgroup Co-chairman John Glaser warned that the information some networks are providing may not be worth buying.
"Frankly, the data is crummy," said Glaser, the vice president and chief information officer at Boston's Partners HealthCare System, explaining that it often contains gaps and biases. He added that a sober and thoughtful discussion should take place before people get carried away with ideas of financing health information networks through data sales.
Later in the meeting, when Glaser mentioned that providers are still the major driver of health information technology adoption, followed by employers and health plans, Intel Corp. Chairman Craig Barrett replied, "Your analysis has to be turned on its head."
Barrett argued that, for all its talk of consumer empowerment, the AHIC was not paying enough attention to consumers and the inherent business power of customer demands.
"If we took this attitude with our customers, we'd be out of business," Barrett said. "Customer demand is going to drive this."
The AHIC backed away from the recommendations of two of its work groups to induce a federal contractor operating a testing and certification program for healthcare IT systems to test personal health-record systems.
The AHIC tabled recommendations by one work group looking into privacy and security issues, and another group looking at ways to empower consumers with more control of their healthcare through IT. The pair of thwarted recommendations were directed toward activities of the Certification Commission for Healthcare Information Technology.
In its Recommendation 1.2, the AHIC Consumer Empowerment Workgroup called on HHS to "support CCHIT in identifying a pathway and timeline for certification of PHRs after adequate industry experience has been achieved in this market. Such certification should include: specifications for PHR privacy and security, interoperability between PHRs and personal health information data sources (including EHRs) consistent with HITSP-identified standards, and PHR portability. CCHIT would need to develop expertise and re-examine its charter in preparation for these activities."
In its Recommendaton 1.2, the AHIC Confidentiality, Privacy and Security Workgroup said: "Where applicable ... CCHIT should develop certification criteria for the systems and networks they certify to support the identity proofing practices in these recommendations."
But AHIC member Kevin Hutchinson, chief executive officer of SureScripts, a for-profit company formed by two retail pharmacy trade associations to promote electronic prescribing, warned against an effort that might be considered pushing CCHIT into an area too soon.
"All of these recommendations won't be a perfect fit with CCHIT criteria," explained Jodi Daniel, director of the office of policy and research at the Office of the National Coordinator for Health Information Technology at HHS and ONCHIT's staffer on the privacy committee. "We wanted to put this on CCHIT's radar screen."