Government Sets Big Health IT Goals, Awards Big Grants

By M.L. Baker  |  Posted 10-12-2005
The Department of Health and Human Services has had a busy week in health IT—it set forth broad goals for using health information, awarded 19 grants totaling almost $40 million for health IT projects, and announced plans to dismantle anti-kickback laws that prevent hospitals and health plans from helping physicians get and use health information technology.

Looking at all the press releases collectively, everything just seems so reasonable. Nothing will happen immediately. No announcements were unexpected, and the money is insignificant compared with the estimated $1.7 trillion the government estimates America spends on health care each year.

Still, this could be a very good thing. The industry needs reliable backing, not flashy, unfulfilled promises, (see my column on Bioshield) and this collection of announcements gives the comforting impression that the government will actually do what it says.

I could do without the rhetoric that throws out terms like "collaborative consensus" and that calls a committee a "community." The rhetoric seems odd coupled with utter faith in market power and promises "to produce value quickly." Perhaps it won't jar me so if interoperability actually happens.

At the first meeting of the American Health Information Community, a 17-member panel convened to advise HHS, I was relieved, that none of the three broad aims could be classified as technology for technology's sake. Instead, these were labeled as consumer empowerment, health improvement and public health protection.

The AHIC members enjoy considerable influence in there own spheres. Just over half the committee is made up of federal officials that control some 40 percent of the health care market, according to HHS Secretary Mike Leavitt. Other members hail from Blue Cross and Blue Shield Association, Intel Corp. and SureScripts, an organization set up by pharmacy and drug store groups to promote electronic prescribing.

Three nationwide efforts to foster interoperability also received funding. The $2.7 million grant to the Certification Commission for Health Information Technology could help quell providers' fears that new clinical systems will be obsolete before they are implemented or that new systems won't work with existing ones.

The biggest grant by far went for working out potential privacy and security conflicts, $11.5 million, given to nonprofit research group RTI International. RTI has joined up with the National Governor's Association to work with some 40 states and territorial governments to work out how to deal with conflicting policies from multistate businesses and state governments, particularly when these requirements go beyond HIPAA. RTI International and the National Governor's Association will work together as the preciously named Health Information Security and Privacy Collaboration (HISPC). It seems to me that the group could have a broader mandate in assessing and preventing risks, perhaps even drafting policies that would mitigate consequences of any health data that are released.

The grant formally gives the government's blessing and backing to an association made by other associations: the National Alliance for Health Information Technology (which represents groups of nurses, insurers, doctors, hospitals and others), the American Health Information Managers Association and the Health Information Management and Systems Society, both broad industry groups that tend to focus on academics and vendors, respectively.

A $3.3 million grant for standards harmonization was reasonably granted to just one institute, the well-regarded American National Standards Institute. A standing joke in health IT is that the field has plenty of standards; any programmer can pick whichever they want. Though ANSI has yet to schedule any deliverables, the grant will hopefully give it both the funds and stature to set real standards.

This week also saw the announcement of over a dozen small regional grants for efforts like managing chronic care to at-risk groups or linking information between nearby health care providers.