Medical Device Daily Washington Editor

WASHINGTON – A Google search of the term “society of association executives” yields more than 22 million hits, so the observation that the U.S. is home to a large number of niche associations is unlikely to raise eyebrows. Indeed, the web site for the American Society for Association Executives (Alexandria, Virginia) boasts more than 22,000 members.

Given that associations have gone forth and spawned so effectively, it seems inevitable that they face dilemmas similar to those experienced by for-profit entities: Just as companies that are set up to make a buck must sometimes merge to stay competitive, some associations must join forces or run the risk of passing into irrelevance.

Thus the Healthcare Information and Management Systems Society (HIMSS; Chicago) and the Association for Electronic Health Care Transactions (AFEHCT; Washington) have decided to move in together in order to make better use of their resources in dealing with the demands of the information age and its impact on healthcare.

The new entity will be known as the HIMSS AFEHCT Business Information Systems Initiative , which, according to the press statement unveiling the link-up, will be in a position to leverage the “subject matter expertise of AFEHCT with the organizational strength of HIMSS” to maximize their influence on policy affecting e-commerce, healthcare transactions and clinical information systems.

The move follows the recent announcement that the Health subcommittee of the House Ways and Means committee came up with a party-line approval of H.R. 4157, a bill that would boost prospects of a national standard for data exchange between healthcare providers and payers, but which would also force providers to adopt an updated diagnostic coding scheme (Medical Device Daily, May 31, 2006).

H.R. 4157 bears substantial differences from the Senate version, S. 1418, which passed last November.

Assuming the House bill makes it to conference, the outcome promises to reshape the landscape for healthcare IT in both clinical and administrative settings, regardless of how the two chambers reconcile their differences, a reshaping that the newly merged organization will be following closely.

HIMSS, founded in 1961, has roughly 17,000 members representing more than 275 member firms that employ more than a million people. AFECHT came into being 31 years later, in 1992, formed by software vendors and other business entities largely in response to the passage of a number of bills that affected clinical data processing systems. (This data coming from the announcement of the merger.)

Steve Lieber, president and CEO of HIMSS, told Medical Device Daily that the merger between the groups took shape fairly rapidly.

“The first conversation [on the merger] would have been in mid-January,” he said, adding that the fusion of the two groups “speaks to the commonalities” they share regarding the increasing overlap between information technology and healthcare.

The toughest part of this marriage, he said, was “being respectful of history and volunteer roles” at AFEHCT.

Thus, the new organization has set about ensuring that HIMSS does not entirely “swallow up” the smaller AFEHCT and “make it disappear.”

Up to now, AFEHCT has had no full-time staff and was run strictly on a volunteer basis. Tom Gilligan served as the organization's executive director and will serve on a contract basis for at least two or three months to help keep members and executives on track in their efforts to mesh their work styles and imperatives.

No employees of HIMSS will lose their jobs over the action.

The operations of AFEHCT will be essentially folded into HIMSS's Chicago headquarters office. But the connection is also made easier by the fact that HIMSS, like AFEHCT, has an office in Washington.

Leiber said that the merger will “expand our advocacy agenda” to include business/transaction issues as well as clinical systems, and that the larger organizational structure “will broaden” its presence on Capitol Hill as well.

The expansion of constituency and policy concerns does not seem to have affected the stand taken by the organizations on current legislation.

Dave Roberts, HIMSS's vice president for government relations, told MDD that HIMSS AFEHCT still “overall supports medical coding upgrades, and our board did endorse” the proposed switch to ICD-10 by the Oct. 1, 2009, deadline proposed in the House bill. Roberts admitted that “it's an aggressive timeline but is something that needs to be done.”

However, he also expects this provision to be the subject of more scrutiny in conference.

Roberts also pointed out that the U.S. and Israel are the only two Western nations that have not made the change to ICD-10.

While legislators must deal with cost/benefit issues regarding the switch to ICD-10, Roberts lauded Congress for its interest “in doing something” about this and some of the other issues addressed in the two bills, but argued that neither fully captures some of the concerns of the IT segment in modern healthcare.

“They need to look at the whole interoperability issue,” something he said that the House Commerce Committee will examine.

Roberts also pointed out that a number of states have laws that can complicate any effort to pass electronic health records beyond state boundaries, noting that this is particularly difficult because the 109th Congress is unusually sympathetic to state's rights.