Critics charge HIMSS-CCHIT connection 'too cozy'

March 06, 2009 | Neil Versel

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CHICAGO – The discovery that the Certification Commission for Healthcare Information Technology (CCHIT) had lost its corporate standing has unleashed a storm of criticisms and false accusations on the Internet and has the organization fighting to protect its reputation.

A Feb. 13 comment on the Wall Street Journal Health Blog revealed that State of Illinois records listed CCHIT, a 501(c)(3) not-for-profit Illinois corporation, as “involuntarily dissolved” as of April 11, 2008.

Though the long, rambling screed by an anonymous commenter contained numerous fallacies, a search of Illinois Secretary of State records in mid-February confirmed that Chicago-based CCHIT indeed had been dissolved. CCHIT corrected the problem, and the record now is listed as “active,” with a Feb. 17 filing date for annual reports.

CCHIT Marketing Director C. Sue Reber blames the involuntary dissolution on an “administrative error,” namely the failure of an attorney for CCHIT to file an annual report with state authorities. “It’s been remedied,” Reber says.

But that was just the tip of the iceberg for the online critics, who posted comments on numerous blogs, some using names that could not be confirmed as real. One pseudonymous writer called CCHIT a “scheme” by the Healthcare Information and Management Systems Society (HIMSS) to escape taxes on millions of dollars supposedly pouring into both not-for-profit organizations.

In his comment, the writer referred to a “revolving door” for personnel between HIMSS, CCHIT and other organizations, noting that CCHIT Chairman Mark Leavitt, MD, once was chief medical officer of HIMSS, but wrongly claiming that Leavitt was still on the HIMSS payroll.

Reber denies those allegations. Although HIMSS, the National Alliance for Health Information Technology (NAHIT) and the American Health Information Management Association (AHIMA), created CCHIT in 2004 and provided some seed money, the commission is an independent entity. CCHIT has operated under a three-year, $7.5 million contract from the Department of Health and Human Services awarded in October 2005, and with revenues from testing fees. The HHS contract has been extended through April and may be in line for another extension, Reber says, in light of the federal stimulus package that includes $19 billion for healthcare IT.

Regardless of the corporate independence, some critics worry that the makeup of CCHIT’s board of trustees and board of commissioners creates serious conflicts of interest and leads to discrimination against small healthcare IT vendors. The trustees, who provide fiscal oversight and corporate governance, are chaired by AHIMA CEO Linda Kloss and include HIMSS President and CEO H. Stephen Lieber as well as a major vendor executive, Glen Tullman of Allscripts-Misys Healthcare Solutions. Representatives of several major vendors sit on the 21-member board of commissioners, which is responsible for setting testing criteria.

Scot Silverstein, MD, an instructor in biomedical informatics at Drexel University in Philadelphia, says no one with a financial interest in CCHIT’s work should sit on either board. “Even the appearance of a conflict destroys credibility,” according to Silverstein. “There’s plenty of people out there with no industry connections whatsoever who are qualified to evaluate technology,” he says.

Reader Comments (2)Login to Post a Comment

pH 7.40 says: times three

April 03, 2009 | 6:10PM GMT

Let's have three separate buy equal entities with overlapping purpose and members to ensure that any windfall would land on all three.

That way no one involved in either/or all three will be missed.

Really, is it seemingly necessary to have three organizations dictate what and who will use whatever?

Systems have been in place in numerous hospitals for more than a decade. These organizations have done zilch to streamline my work or documentation. Not to mention each being proprietary software and therefore none communicate with each other. And nor do any of the insurance companies want to give each other the time of day.

Is it too much to ask to have one system in place so I, my department, my office, my billing does not have to work inside a dozen or more software systems to all ultimately do the same task?

Or is there simply too much money to be made to entrust anyone to do this much needed task?

I can not imagine the amount of money already wasted on needless products, support, service and software, not to mention yearly license fees, for systems that do not work and do not communicate with one another.

We are not going to fix this problem using the same model and modalities that led us to this point in time.

You can not solve the problem using the same think/speak that got us here.

scotsilv says: On conflict of interest and HIT industry validation

March 10, 2009 | 7:41PM GMT

Regarding appearance of conflict of interest, I would like to add that medical technology tester The ECRI Institute has a robust approach. From their web page:

Conflict of Interest - The Integrity of Independence

"Remaining unbiased is difficult, if not impossible, when conflicts of interest are present [indeed - ed.] That is why we strictly enforce our conflict-of-interest rules and have carefully developed an environment that maximizes objectivity, productivity, and integrity of process. We accept no grants, gifts, finder’s fees, or consulting projects from, and our employees are not permitted to own stock shares in, medical device or pharmaceutical firms. To make sure that is the case, we examine each employee’s federal income tax return after it is filed. And, we accept no advertising revenues from any source."

This type of policy gives their reviews credibility both to physicians and to consumers skeptical of the healthcare industry.

As to an investigation of the HIT industry by Congress, we do not have reliable figures for the morbidity and mortality caused by health IT, have conflicting data on its benefits, and yet these devices are being relentlessly pushed onto the public without the public's consent. This is a patient's rights issue.

It is also troubling that pharma's clinical trials and other information systems are subject to federal validation and inspection, yet clinical IT used in patient care is not so regulated, even though such systems are more complex and have a more immediate and potentially irrevocable impact on patients.

There seems to be very little information sharing on HIT defects.

I wrote that due to these factors and other issues that "a congressional investigation of the HIT industry's development, marketing, talent management, contracting, QC, and information sharing practices (on bugs, UI problems and other defects) is warranted."

-- S. Silverstein