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Group Seeks Sway Over E-Records System
Health Association With Ties to Stimulus Lobbying Effort Pursues an Oversight Role

By Robert O'Harrow Jr.
Washington Post Staff Writer
Thursday, May 21, 2009

A health technology trade association has asked the Obama administration to require that any electronic health-record equipment receiving stimulus funding be certified by a group the association helped to start and run, documents show.

The Healthcare Information and Management Systems Society, which represents 350 technology vendors and 20,000 members, was a key force behind the decision to include $36.5 billion in the stimulus package to create a nationwide network for medical records.

A Washington Post review last week showed that the group, known as HIMSS, worked closely with vendors, health-care researchers and others to create nonprofit advocacy groups and generate research data to convince policymakers that such a system could save tens of billions of dollars, and that the government needed to subsidize Medicare and Medicaid providers to buy the equipment.

The government estimates that adoption of electronic health records will yield perhaps $17 billion in savings over the next decade.

Now the health information group is urging officials at the Department of Health and Human Services to give an organization called the Certification Commission for Healthcare Information Technology, or CCHIT, responsibility for deciding what health records systems are eligible to receive stimulus spending.

"To ensure continuity, recognize CCHIT as the certifying body" of electronic health records, HIMSS officials wrote in an April 27 letter to the Health and Human Services Department.

At issue is language in the stimulus bill that mandates that the government provide reimbursement only for equipment that enables "meaningful use" by doctors, hospitals and others. Government officials, technology vendors, doctors and patient advocates are engaged in a debate over the definition of "meaningful use."

Critics in the health-care industry have expressed concern that the certification commission is too close to information technology and health-care companies to be the best judge of what equipment doctors and hospitals ought to buy. Although the group is funded through a contract with Health and Human Services, it is run by a former HIMSS executive and one trustee also is the president of the trade group. Several board members work for technology vendors.

David C. Kibbe, a doctor and senior adviser to the American Academy of Family Physicians, said CCHIT has in recent years helped the industry develop features in electronic health records systems. But, he said, "it's a very different thing when federal taxpayers' monies are channeled through such an organization."

"One has to question whether or not a vendor-founded, -funded and -driven organization should have the exclusive right to determine what software will be bought by federal taxpayer dollars," Kibbe said. "It's important that the people who determine how this money is spent are disinterested and unbiased . . . Even the appearance of a conflict of interest could poison the whole process."

Mark Leavitt, the former chief medical officer at the health information group who now runs the certification commission, said he expects that his organization will be "the body or one of several certifying bodies that are recognized" by the government, in part because it is currently the only certification group for health information technology.

He said the commission goes to great lengths to ensure that vendors do not dominate the group's activity. He said some critics are technology vendors whose systems don't meet CCHIT standards.

"We have a responsibility to make sure this money isn't misspent," he said.

The certification commission was founded in 2004 by the health information group and two other industry organizations. In 2005, Health and Human Services awarded the commission a three-year, $7.5 million contract.

Leavitt took a leave from his job at the health information society to lead the certification commission. According to documents filed with the IRS, Leavitt was technically paid by HIMSS, which was reimbursed for his salary by CCHIT. That pay arrangement continued through last year, Leavitt said. Leavitt said he answered only to CCHIT board members. "I was not supervised by HIMSS," he said.

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