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Wanted: A George Washington for Health IT

By John Reichard, CQ HealthBeat Editor

August 17, 2007 -- The way HHS Secretary Michael O. Leavitt sees it, a dynamic new figure is needed to lead the next stage of the nation's adoption of health information technology—and it ain't him. Government must play a major role in lowering barriers to the spread of the technology, but putting a government leader in charge of that effort will muck things up, Leavitt said Friday.

Bringing the issue of leadership to the fore is the current effort by the Department of Health and Human Services to phase out the "American Health Information Community" (AHIC), a HHS advisory group formed by Leavitt in 2005 to find ways to speed adoption of health information technology. AHIC should give way to a public–private advisory body that continues the work of developing and adopting standards to ensure that the different components of health information technology systems function smoothly together, Leavitt said.

At a meeting Friday on efforts that are underway to find an AHIC successor, Leavitt said "this meeting, in my judgment, is about asking the question, 'who is George Washington? Who should be the entity that forms up AHIC 2.0 in terms of its concept?'" Although some say that leader ought to be the head of HHS, "I would suggest to you that in a political environment that may not be the right answer."

Too large a government leadership role is a bad idea for several reasons, he said. One is that in 17 months there will be a transition of the kind that happens every four years with presidential elections, he said. That could mean months of delay in changing federal leadership of health IT, he said.

"This organization ultimately needs to have an executive team that has continuity to it, that isn't done by political appointment," he said. "Another thing I would mention is the need for a business model. If Congress has to continue to appropriate money to this, and someone gets unhappy with it, then there's no certainty to it if they can defund it, in essence."

What's needed is a George Washington-type figure—or organization or organizations—that can bring competing points of view into the debate over furthering the field without bogging it down; what Leavitt referred to as bringing together "the Alexander Hamiltons and the James Madisons in a process that will bring balance."

But while Leavitt clarified that government can go too far, he also suggested that if government is too timid, the field won't move forward. Government money won't be used to fund health IT systems that don't comply with standards coming out of the work of the AHIC successor group, he said. Emphasizing that government will be a major player in that successor group, Leavitt said "I underscore the word 'major' because we're clearly going to be one of the biggest payers."

HHS is inviting organizations to apply for a two-year $13 million grant to design, establish and operate the successor group to AHIC. That grant will be awarded this fall with the goal of launching the successor in the spring of 2008.

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