HHS to Take Over Review of Health Records Technologies

By Robert O'Harrow Jr.
Washington Post Staff Writer
Saturday, August 15, 2009

The Department of Health and Human Services is almost certain to take on responsibility for creating the criteria used to decide what health records technologies qualify for billions of dollars in reimbursements to medical offices under a new stimulus program, officials said Friday.

The decision represents a significant restriction of the role played by a private certification group, begun several years ago by the technology industry, which until recently had served as the government's gatekeeper for endorsing systems designed to improve the sharing of medical records.

The Certification Commission for Healthcare Information Technology, or CCHIT, came under sharp criticism in May after a Washington Post story showed that it has close ties to a trade group whose members stand to receive billions as a result of the stimulus legislation.

The trade group, called the Healthcare Information and Management Systems Society, was a key force behind the Obama administration's decision to include $36.5 billion in the stimulus package for development of electronic health records networks.

Under the stimulus legislation, doctors and medical organizations can be reimbursed for buying equipment that is certified as meeting certain mandates, including that the gear provides "meaningful use" to improve information sharing.

The nonprofit certification commission was started in 2004 with support from the trade association and two other industry groups. In recent years, it has received funding through HHS, but it is run by a former executive of the trade association and one of its current trustees also is president of the association. Several board members work for technology companies.

Critics of the certification group have complained that apparent conflicts of interest would undermine the group's credibility in judging deciding what technology merited stimulus funding.

"There was an apparent conflict. . . . We don't want to spend the next several years on a sideshow," said Paul Egerman, co-chairman of the advisory group that recommended that the HHS, instead of the private group, should set the criteria.

"Our energies need to be focused on the substantial challenges involved in getting physicians to use these systems effectively while, simultaneously, earning the public's trust in the privacy and integrity of these systems."

The recommendations of Egerman and several others were endorsed by a government health information technology advisory board Friday. That development virtually ensures the recommendations will be formally embraced, after a public comment period, by the National Coordinator for Health Information Technology at the HHS.

Mark Leavitt, who runs the private certification commission, acknowledged that his group will play a different role going forward. But he said it will continue to certify technology, according to the standards set by HHS. It also will offer a "higher level of certification that includes HHS but goes beyond" to help medical organizations shop for the best systems, while providing technical advice to the government, Leavitt said.

Because the amount of money involved in the program "is so great," Leavitt said, "you need the federal government involved" in setting the standards and criteria.

Critics praised the developments. "It's definitely in the public's interest, and will remove serious questions of conflict of interest that should give the market new confidence and result in more affordable EHR technology," said David C. Kibbe, a doctor and senior adviser to the American Academy of Family Physicians.

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