It is a tale of three committees: one fading into history, a second forming to take its place and a proposed third that might supplant the first and render the second moot.
On Nov. 12, the American Health Information Community is scheduled to meet for its 25th and, perhaps, final meeting. AHIC, which was created in 2005 by HHS Secretary Mike Leavitt to advise him on healthcare information technology policy, is being converted into a privately run and managed not-for-profit group called AHIC Successor.
But the new AHIC may be overshadowed next year by a proposed new federal oversight committee that has the backing of powerful lawmaker Rep. Pete Stark (D-Calif.), a move opposed by the Healthcare Information and Management Systems Society.
For now though, AHIC Successor is moving forward with its plans as the lead group on advancing the implementation of electronic health records. Late last month, AHIC Successor released the names of 15 people selected to serve on its first board of directors.
The group expects to hold its first meeting as the full-fledged AHIC replacement Jan. 1, 2009, according to one of the new groups co-founders, John Tooker, executive vice president and chief executive officer of the American College of Physicians. AHIC Successor aims to be an independent, public-private partnership representing all elements of the health community to accelerate emergence of a nationwide interoperable health information system, according to its published statements.
But the new groups board lacks completely what the first AHIC had: strong representation from the federal government. When Leavitt picked the initial 17 AHIC members (he named himself chairman), the panel included eight federal employees and a state health official. In contrast, the AHIC Successor has no federal employees and only one state worker. Only two AHIC Successor board members are carryovers from Leavitts AHIC.
The 15 were chosen from a list of 30 finalists by physicians John Glaser, vice president and chief information officer of Partners HealthCare System, Boston; Jonathan Perlin, chief medical officer and president of clinical services of HCA; and the ACPs Tooker. The three served as incorporators of AHIC Successor when it was launched on July 17. The three will serve as board members for one year, and then step down without replacement.
Tooker said the extent of federal participation in the new organization was the subject of a very interesting conversation all summer long.
In the present structure, the federal government will appoint two liaisons and the (HHS) secretary will be one of those two liaisons and the office of the national coordinator will also serve in an advisory capacity to the board, Tooker said. That leaves the nations largest payer, Medicare, and its two largest provider organizations, the Veterans Affairs Department and the Military Health System, without a full say on the national IT advisory panel. Thats because none of the three federal employees attending AHIC Successor board meetings will get to vote on AHIC Successor business, Tooker confirmed.
The recommendation was that the federal government participate to the fullest extent possible, Tooker said. After looking at a variety of models for governance, however, he said the framers of AHIC Successor decided on creating a fiduciary board.
According to the advice of legal counsel, the most recent ruling is the federal government cannot serve in a fiduciary capacity on this board, Tooker said. That is why they are conspicuously absent. Its not because we wouldnt like them to participate, he said.
The discussion of AHIC Successors board may be for nothing if Stark, chairman of the House Ways and Means Health Subcommittee, gets his way. On Sept. 15, Stark introduced the Health-e Information Technology Act of 2008, another new healthcare IT booster bill. The chances of the bill passing this legislative session, already in overtime, are nil. But if the Democrats retain control of the House in 2009, the bill could gain traction on Capitol Hill in the next administration.
The Stark bill contains an entire section on establishing a government-funded HIT Advisory Committee that would operate under the Federal Advisory Committee Act. It specifies that the authority to appoint members to the committee shall be shared between the president, the HHS secretary, the bipartisan leadership of both houses of Congress and the comptroller general, who heads the Government Accountability Office. The comptrollers picks are to include a representative of organized labor in the healthcare industry as well as members with expertise in open-source software development, quality improvement, consumer advocacy, privacy and security, research, vulnerable communities, payers and providers.
The pending legislation already has elicited a letter of protest from the Chicago-based HIMSS. The trade group took issue with Starks proposal to create a federally run health IT advisory committee as well as language that calls for the Office of the National Coordinator for Health Information Technology at HHS to provide for coordinating the development, routine updating and provision of an open source health information technology system that is either new or based on an open source health information technology system, such as VistA, the public domain clinical IT system at the VA.
Establishing Starks federally funded HIT Advisory Committee would dismantle the work that the federal government and private sector have already achieved in transitioning the federal healthcare IT advisory committee, the American Health Information Community (AHIC), into the private sector, said the letter, which was signed by Stephen Lieber, president and CEO of HIMSS, and Charles Christian, the director of information systems and chief information officer at 232-bed Good Samaritan Hospital, Vincennes, Ind., who is serving as chairman of the HIMSS board.