May 6th, 2009
Certification the tip of the health reform spear
In their third open letter to the National Coordinator for Health IT, now identified as Dr. David Blumenthal, David Kibbe and Brian Klepper make clear something that is becoming increasingly obvious.
Health IT certificiation is the tip of the reform spear.
(That’s the slogan on this logo for the 1st Light Armored Reconnaissance Battalion, US Marine Corps, from which the image was borrowed.)
Their letter calls the issue “the elephant in the room,” but the issue represents in microcosm the larger problems bedeviling health reform, problems that could easily derail it.
The current system is filled with incumbents, whose interests are their own and not that of the system. This is also true in health IT where CCHIT, a group created by incumbent suppliers, is due tol certify computer gear eligible for aid under the HITECH portion of the Obama stimulus.
Open source advocates went before the group at the HIMSS show and received a hearing, but Klepper and Kibbe want more. They want CCHIT displaced. Not replaced, disbanded or replaced. They just want its monopoly on certifying IT for HITECH ended.
“A new certification process could be streamlined in ways that encourage rather than stifle innovation,” they write.
Rather than detailing what tools must do to reduce risk, as CCHIT head Mark Leavitt recently testified, Dr. Blumenthal should certify any systems with basic capabilities, then let the market do the rest, they write.
Shedding the bloated feature set now required for certification in favor of a “thin certification” based on data exchange and management would immediately stimulate the health IT economy. It would also focus Congress’ understanding of “meaningful uses” that it hopes will encourage health IT among physicians and hospitals.
I agree. The best standards are basic. They enable innovation and accept change. The standards under which your browser is reading this blog post is an example of that. Those standards accepted standard Web pages, data-driven pages written on the fly, and the creation of social media.
The authors end with this warning, which is so powerful I decided to summarize it as the headline for this post:
If the process moves forward as it is currently configured, a not-for-profit agency that is dominated by industry interests and that promotes technology that is largely outdated will have succeeded through its policy influence in securing much of that funding while holding newer, less costly, better technologies at bay. If that occurs, it will not only be yet another serious compromise for American health care’s future, but it will signal that other important elements of meaningful health care change - universal coverage, a re-empowerment of primary care, greater quality/cost transparency, paying for results instead of procedures - will be equally elusive.
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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| 05/06/09
