Speaking at a series of industry meetings, including the 2005 HIMSS Summit, Leavitt said he would immediately charter and chair the American Health Information Community under the auspices of the Federal Advisory Committee Act.He said AHIC will act as a leadership forum for both governmental and private interests to harmonize standards; recommend a national architecture that uses the Internet to share health data among providers; ensure patient privacy and information security and pave the way for a private-sector replacement when the charter sunsets after five years.
AHIC will include 17 commissioners representing all stakeholders and perspectives, Leavitt promised. It will be guided by a series of advisory groups. The secretary said he would chair the commission because it would become a key lever in the effort to transform the delivery of healthcare in the United States.
Leavitt left no doubt about his views of the role he envisions for healthcare IT. Likening the status quo to the 19th century system of regional rail lines – all of which used different rail gauges and thus could not interconnect – Leavitt said "Our standards problems are thorny; they have to be solved, and the sooner we solve them, the better off we all are."
He included healthcare IT as one of three "big gears" that will change the nation's health system, along with a renewed emphasis on wellness and a dramatic realignment of incentives.
The secretary was equally adamant, however, that AHIC and other steps HHS is about to take into the healthcare IT field are not "federal" programs but national ones. While AHIC is likely to include representation from government agencies such as the Centers for Medicare and Medicaid Services, the departments of Defense and Veterans Affairs, it is also likely to include private sector interests, such as major payers, providers and consumers. "It is guided collaboration," Leavitt stressed.
Adoption incentives to come
The new community will not create new standards for interoperability, nor will it certify products or write software code.
The scope of AHIC is limited to questions regarding interoperability. When HIMSS CEO H. Stephen Lieber asked about closing the adoption gap between larger providers and small medical groups and solo practitioners, Leavitt said the government planned to create incentives to improve adoption. But those would be spelled out in "a few weeks."
"AHIC is about standards," Leavitt said. "This isn't the place where questions about money or infrastructure will be answered."
AHIC will be formally chartered in July for two years, with an option to renew for an additional three years. It would be followed up by a private-sector health information community initiative, similar to those that exist for Java development and the open-source Linux platform, that would carry on the work.
By 2010, AHIC would develop and make recommendations on the adoption of a non-governmental standard-setting and certification process, lay the groundwork for a national data interchange and highlight applications that provide immediate benefits.
But Leavitt said no one should wait until 2010 to proceed. "Rather than do this all at once, we will work on breakthrough projects," he said, eyeing a timeframe measured in months rather than years. "The key to this is early deliverables," such as e-prescribing and electronic lab results.