Diagnostics & Imaging Week
Department of Health and Human Services (HHS; Washington) Secretary Mike Leavitt this week reported the creation of a commission to be chaired by Leavitt that will work to develop standards to ensure that most Americans have electronic health records (EHRs) in this decade, a mission handed down from President George Bush.
Speaking at a meeting in New York sponsored by the Healthcare Information and Management Systems Society (HIMSS; Chicago), Leavitt said that in coming weeks he would be filing the charter of the American Health Information Community (AHIC).
He also said that he would issue four requests for proposals the following day. David Brailer, national coordinator of Health Information Technology, would address RFPs after their issuance, Leavitt said.
Leavitt told the audience at the HIMSS Summit-Achie-ving National Healthcare Transformation, as well as listeners on an audioconference, that these measures "will dramatically intensify the pace of progress in health information technology."
HIMSS defines an EHR as a "digital collection of a patient's medical history and could include items like diagnosed medical conditions, prescribed medications, vital signs, immunizations, lab results and personal characteristics like age and weight."
President Bush has directed that payors and providers move toward EHRs to simplify the vast record-keeping involved in the healthcare industry. Leavitt said that clinicians today don't have a guide as to the best way to go about transitioning to EHRs in their practices. In fact, he said the whole industry "can't afford to be wrong" about which direction it takes with technology.
In total, HHS will spend $86.5 million on health IT in FY05, and Bush has requested $125 million for health IT in FY06.
"The president intends to have the AHIC, as we'll refer to it today, [as] the place where major government players, such as the Centers for Medicare & Medicaid Services, [the Department of] Veterans Affairs, the Department of Defense [will come together]," Leavitt said. "It's the place where they will join together with private payers, provider groups, and vendors and consumer organizations, as well as state and local government interests, to [form] a common framework that achieves interoperability."
AHIC will be formed under the auspices of the Federal Advisory Committee Act. The charter for AHIC will call for the body's dissolution within five years and will set forth the process for creating its successor body.
Leavitt said AHIC would be "open, transparent, inclusive collaboration." He said he would solicit nominations for people to serve on the AHIC and from those will appoint 17 commission members. There also will be an "advisory system" to the AHIC designed to enlist broad participation by a variety of groups. He said he was making the decision after consulting with some of the largest private payors in the country, employers, providers, technology vendors, consumer advocates, privacy advocates, and leaders of Congress and state officials.
"It's clear to me that the challenge of health IT and its vendor interoperability is so compelling, it's such a significant national problem, that it's going to require an unusual and extraordinary measure to be sure that it occurs," Leavitt told the audience.
However, he also said that AHIC would be formed as a standard-setting body only and will not be "an entity that's building infrastructure or an entity that's writing software code." He stressed that AHIC will "build upon the vast amount of standardization that's already achieved inside and outside the healthcare industry."
AHIC will have five specific tasks, with the first being to make recommendations as to how to protect privacy and how to protect security.
"I want to be very clear that the first principle in dealing with this is that the records of Americans need to be protected," Leavitt said.
Second, he said, AHIC will be "identifying and making recommendations for prioritized health information technology achievement." Also, AHIC will address certification and certification compliance.
Finally, Leavitt said, "We need to make recommendations for a nationwide architecture that uses the Internet to carry healthcare information that's secure and timely in its manner."
The RFPs to be issued today essentially mirror the tasks set forth by Leavitt for AHIC. Specifically, they will ask for private-sector participants to offer methods of creating non-governmental standards that will "harmonize" the process and product compliance certificate process. The RFPS also "will invite groups to propose an Internet-based architecture and a nationwide health information exchange." Another RFP will seek to assess variations in patents in patient privacy and security matters.
Leavitt also emphasized that he will set an aggressive timetable to see results quickly.
"I want this to work rapidly; speed is life here," he said. "We need to see deliverables and see them quickly, and I think within a matter of months — not years, months — we need to start seeing the results of this work."