Big Decisions Await HHS Secretary

June 24, 2011
Kansas Gov. Kathleen Sebelius will have a very full in-box awaiting her at the Department of Health and Human Services, and a lot of people anxiously

Kansas Gov. Kathleen Sebelius will have a very full in-box awaiting her at the Department of Health and Human Services, and a lot of people anxiously awaiting her decisions.

First, she may or may not decide to replace Robert Kolodner, MD, as National Coordinator for Health IT. But she will definitely have to decide the fate of some current policy and standards groups and help with the formation of several new ones.

The American Recovery and Reinvestment Act calls for the formation of a new HIT Policy Committee and an HIT Standards Committee, both of which are already accepting nominations and resumes. The Policy Committee, which doesn't have an obvious existing predecessor, will make recommendations to the Office of the National Coordinator regarding nationwide infrastructure and the federal health IT strategic plan.

The Standards Committee is charged with recommending standards, implementation specifications and certification criteria needed to achieve interoperability.

Sebelius has only until Dec. 31 of this year to adopt its initial set of standards.

One of the issues that she will have to decide immediately is whether the Standards Committee will evolve from the National eHealth Collaborative (NeHC), the public-private partnership successor to the American Health Information Community (AHIC), or whether to form a new group entirely. NeHC has put out a press release noting that its goals and that of the HIT Standards Committee are highly complementary, and that it is looking forward to playing that role.

It also seems likely, but not yet definite, that the Healthcare Information Technology Standards Panel (HITSP) will continue its standards harmonization work, implementing the recommendations of the Standards Committee, as it did for AHIC.

Finally, Sebelius must decide whether the existing Certification Commission for Healthcare Information Technology will continue in its current role.

Dr. Mark Leavitt, CCHIT's chair, stresses that the act's provisions put the word "certified" before EHR in every case where financial incentives for adoption and meaningful use are mentioned.

In a March 11 HIMSS webinar presentation, Leavitt called ARRA the biggest thing that's ever happened in health IT, and compared the challenge to NASA's manned spaceflight to the moon in the 1960s. Continuing with that analogy, he said that he and CCHIT are "ready for the rocket ride" that the escalation in EHR adoption will bring.

Leavitt said the organization has seen a surge of new applicants, and he is confident that that CCHIT will continue the work it has been doing since 2006. He noted that the law calls for meaningful EHR adoption just 20 months from now, on Jan. 1, 2011. "I don't think there's time for a new credible certification program to be developed by then, just from a practical standpoint," he said. Leavitt added that with so much work ahead of it, he couldn't imagine the Office of the National Coordinator for Health IT re-inventing the certification process with a whole new organization.

CCHIT has been criticized by smaller vendors, who accuse it of creating an uneven playing field. Leavitt did admit that CCHIT has its flaws and needs to improve. For instance, he said it would seek to address concerns about certifying open source and self-developed EHRS.

So what do readers think? Should Kolodner continue to head up ONCHIT? Should NeHC morph into the HIT Standards Committee? Should HITSP and CCHIT retain roughly their current roles?

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