View from the Hill: National News at HIMSS Leadership Summit


July / August 2005

View from the Hill

National News at HIMSS Leadership Summit

Even though it is summertime, we are in the midst of dramatic developments forÝimproving patient safety. Secretary of Health and Human Services Michael O. Leavitt and National Coordinator for Health IT David Brailer, bothÝrecently announced important federal initiatives. Most notably, the formation of an American Health Information Community (AHIC)Ýand the release of four requests for proposal (RFPs) designed to advance interoperability of health information and achieve widespread adoption of HIT. CongressÝacted in June as well, approving Secretary Leavitt’s request to move funds originally earmarked for specific projects and shifting $32.8 million in fiscal year 2005 funds to the Office of the National Coordinator for Health IT to begin these initiatives.

Secretary Leavitt’s Focus
Secretary Leavitt delivered a landmark announcement at his keynote presentation for the HIMSS SummitÝon June 6 in New York City. After describing his mandate from President Bush to help Americans live longer, healthier lives while maintaining a prosperous U.S. economy, Secretary Leavitt enumerated his three high-level goals for transforming healthcare in the U.S.: First, shifting the cultural mindset from treatment to wellness and prevention; second, realigning incentives so we will “pay for performance”; and third, widespread adoption of standards-based, interoperable health IT. The Secretary expressed his strong personal commitment and his belief that the third goal of HIT was a prerequisite to achieving the first and second goals.

Formation of an American Health Information Community
Secretary Leavitt announced a bold new initiative: theÝformation of the American Health Information CommunityÝ(AHIC), to serve as a national standards and policy body to make recommendations to the federal government on how to achieve interoperable electronic health records that assure privacy and security. TheÝAHIC, which will receive top-level attention from the White House and federal agencies, will be chaired by Secretary Leavitt and include up to 17 commissioners nominatedÝfrom a wide constituency, including clinicians, consumer groups, vendors, and state and federal government representatives.

Health IT Requests for Proposal
At the HIMSS Summit in New York City on June 7, Dr. Brailer displayed renewed energy as he announced the release of four RFPs as part of a contracting process to address fundamental issues critical to achieving an interoperable NHIN and driving EHR adoption. The RFPs are as follows:

• Standards Harmonization: A single award contract to develop, test, and evaluate a feasible prototype standards harmonization process.

• Certification: A single award contract to evaluate the feasibility and effectiveness of a compliance certification and inspection process for EHRs.

• Prototypes for an Internet-based NHIN Architecture: Six awards for prototypes of Internet-based interoperable NHIN architectures. Prototypes must be able to function in real-world settings in a non-proprietary fashion.

• Privacy and Security Solutions for Health Data Exchange: A single contract with up to 40 subcontracts with designees of state or territorial governments to review state and local interpretations of privacy and security regulations to determine challenges and possible solutions for achievin smoother transmission of healthcare data.

Following Dr. Brailer’s talk, the halls were buzzing with discussions as people considered partnerships and potential collaborations to respond to the RFPs. Once more, the pace of changeÝin improving healthcare using information technology and management systems has accelerated.

Funding for HIT Efforts
Another long-awaited development is the confirmation that Congress has approved the reprogramming of $32.8M to the Office of the National Coordinator for Health IT to fund many of the FY05 initiatives we have outlined. HIMSS applauds the House and Senate Appropriations Committees’ recognition of the importance of healthcare IT to addressing many of the healthcare delivery challenges facing providers, institutions, states, and the federal government. The reprogramming will have an impact on healthcare IT; however, there is still much work to do. The fiscal year 2006 appropriations process is in full swing. We are working closely with our colleagues around the industry to ensure the President’s Budget Request of $125 million is approved by Congress. The House Appropriations Subcommittee on Labor and HHS markedÝup their billÝinÝJune. HIMSS understands the President’s request for health IT is included in the draft.

However, as we saw in last year’s legislative process, a lot can happen during the markup of legislation.

HIMSS Summit attendees also heard from U.S. Representative Patrick J. Kennedy (D-RI), co-chair of the 21st Century Health Care Caucus and winner of the 2004 HIMSS Advocacy Award. He is working with key Capitol Hill House leaders to pass a healthcare IT bill this year that provides demonstration funding, Stark Reform and anti-kickback safe harbors, and incentives for providers participating in regional efforts. Kennedy promoted H.R. 2234, the 21st Century Health Information Act, which he co-sponsored by Rep. Tim Murphy (R-PA), as one such key piece of legislation. Kennedy also announced that the U.S. Senate is working to organize an HIT caucus similar to the caucus he co-chairs in the House of Representatives. Kennedy closed his remarks by saying that “lives hang in the balance in the most real sense. You can make this change happen. I look forward to working with HIMSS to making this change happen this year.”

Also in June, Senators Olympia Snowe (R-ME) and Debbie Stabenow (D-MI) introduced new legislation known as the Health Care Quality Improve Act of 2005, which will provide substantial investments in information technology and management systems to improve the quality, safety, and efficiency of patient care. This legislation is receiving much attention because itÝproposes to create a grant program that will infuse the provider community with almost $4 billion in federal funding to encourage adoption of information systems and services. The bill also emphasizes interoperability that address the needs of providers in diverse geographic settings, including setting aside at least 20 % of the grant money for rural communities.

Stay Tuned
HIMSS applauds the announcements by Secretary Leavitt, Dr. Brailer and Congress this week. There is more to come, and we will provide updates as new developments occur. The Society has long recognized the importance of healthcare information and management systems to providing quality and cost effective healthcare. We are encouraged by the government’s recognition that healthcare IT is a non-partisan issue of national importance and agree that guided collaboration is the path to success. As the private sector has a fundamental stake in this game, HIMSS will demonstrate its ability to lead through offering credible insight focused on the common good.

Dave Roberts is HIMSS director of public policy. Formerly a professional staff member for both the U.S. House Appropriations Committee and the U.S. Senate Health Subcommittee on the Handicapped, and a civilian financial analyst for the U.S. Air Force, Roberts now resides with his family in Solana Beach, California, where he is an elected member of the City Council and maintains a HIMSS office in Alexandria, Virginia.