Thursday, February 19, 2009

HisTalk defends CCHIT

(Addendum Feb 23 - see some answers here.)

The HIT industry sponsored "Healthcare IT News and Opinion" website HisTalk has taken to the defense of CCHIT in the recent controversy raised by a number of bloggers and commenters.

Below I comment on what was written at HisTalk here about my HC Renewal item A very troubling post about the CCHIT -

(not sure if my followup
"Is CCHIT Registered as a 501(c)3 in Illinois, And if Not, Where is it Registered, and Why Was it Involuntarily Dissolved in April 2008?" was included in the HisTalk critique):

Don’t get too excited - nearly every point in the "very troubling post" is wrong, starting with the first paragraph (HBOC is indeed the former HBO & Company).

First, I agree. Nobody should get excited. In a"code blue" situation, as we physicians like to say, the first thing to do is take your own pulse.

However, I also don't think we should ignore this material. The implications are too important to the ultimate customer of all of our services - patients. And that includes ourselves when we find ourselves in that role.

Mr. HisTalk first points to my rather obvious typo about the differentiation of the HIT company whose former CEO was cooking the books from an entertainment company, i.e, regarding HBOC not being the same company as HBO. My accidentally adding "& Co." to the latter was surely the important point here, bar none. Well, not really.

I have since corrected the typo, and thank Mr. HisTalk for being so kind as to point it out, although using it as a point of discreditation seems just a bit harsh.

CCHIT was dissolved, but only to change its organization type.

Mr. HisTalk left out an important word.

The word is "involuntarily."

CCHIT was involuntarily dissolved for reasons unknown. Perhaps Mr. HIStalk through his HIT industry benefactors can enlighten us on the reasons. It probably is on a mundane issue as in my link to a book on such dissolutions in one state, but I for one would like to see the details from the State of Illinois. I'm sure others would as well in this age of unflattering business conduct. Some of the possible reasons for involuntary dissolution at that book are disconcerting.

CCHIT is still a private, non-profit organization and it’s entirely irrelevant as to which state it’s incorporated in since you don’t have to incorporate in the state in which you operate (surely everyone’s heard of the huge number of Delaware and Nevada corporations out there).

Perhaps; I am no business expert regarding where nonprofits need to be registered. I would agree with Mr. HisTalk here, that it may not matter in which second state a nonprofit chooses to be registered, except when the dissolution in state #1 was involuntary for some reason. Probably was for mundane reasons as I wrote, and if so I'll be the first to say "great!", but also might not be innocent. I simply do not know.

(Addendum 2/19/09 11 AM PST- it appears state of registration is not entirely irrelevant to CCHIT, as CCHIT is apparently re-registered in Illinois. The CyberDriveIllinois site today shows CCHIT as "Active" with an Annual Report Filing Date of - 2/19/09. I am not aware of what happened behind the scenes that led to this. Government error? CCHIT error? Something else?)

I am also still curious as to exactly where CCHIT is now registered. I cannot ascertain this from its website. Perhaps I'm missing it. I would welcome being pointed to the page if that is the case.

Conflicts of interest with HIMSS? Obviously - HIMSS, AHIMA, and NAHIT founded it in 2004, so clearly they share an agenda and aren’t exactly secretive about that fact.

This is a rather lame excuse to ignore this issue - 'the organizations were once joined at the hip and so clearly share an agenda, and aren't secretive about that.' One wonders where that argument would go in my former hunting grounds, the pharmaceutical industry. Come to think of it, the dismissive post at HisTALK blog is starting to sound a bit like that industry and its trade association, PhRMA.

Mark Leavitt of CCHIT used to work for HIMSS, but left to take the CCHIT job. CCHIT has paid staff, but most of the work is done by volunteer commissioners. CCHIT’s criteria are publicly vetted and open for anyone to see, so it’s not like they’re doing some kind of beauty pageant judging with no oversight.

Again, in my post I wrote: ... if CCHIT operates independently of HIMSS, AHIMA, and NAHIT [as stated by its marketing director], why are individuals from some of these organizations acting as Trustees? Why are vendor officials acting as Commissioners? It simply doesn't matter, I guess. No way such associations can affect decisions about anything important in any domain in any manner. I also wonder how that would go over in pharma.

As I wrote earlier, medical technology tester The ECRI Institute has a different approach:

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.

Mr. HisTalk continues:

I could go on, but clearly it’s a waste of time — someone with an axe to grind decided to air their prolific ignorance or denial of the facts publicly.

It seems someone whose site bears more than a dozen industry sponsor logos in its left column might have an "axe to grind" too. I take no money from anyone, blogging as part of my occupation of medical informaticist and physician. However, I believe the debate should go on without resorting to "axe to grind" attacks. We all have axes to grind.

I do believe, however, that "CJ" should let us know more about him/herself.

The legitimate gripes about CCHIT are its fees (but it is a self-supporting nonprofit), its existence (but Brailer sold the world on CCHIT-certified EHRs for interoperability reasons even though most of the CCHIT criteria have nothing to do with interoperability), and its failure to get its stated job done (reducing EMR purchase risk of doctors to move the adoption needle).

I have no disagreements there, except to the term "The." I might say "Some legitimate gripes."

I can add a gripe regarding the potentially (mis)leading word "certification." To the uninitiated in general and to the non medical, non IT executive in particular, this word carries a heavy weight regarding fitness for purpose. A better description of CCHIT's activities might be "qualification" of HIT feature set and operations.

Finally, CJ has posted yet another comment here at the WSJ blog, bringing up HIMSS' acquisition of Government Health IT news among other items, which due to its strategic governmental audience would potentially make an excellent force multiplier for a lobbyist organization ... and its associates.

I again cannot vouch for his comments. They might lack merit, or they might be important. In any case, they are interesting and worthy of discussion, not spin.

(I note that after the takeover, my webcast at Government Health IT News on "HIT irrational exuberance" seems to have disappeared. Again, probably innocent.)

Finally, I can say this:

How anyone can blithely dismiss the writings of a person on a mission such as "CJ" just months after scandals such as the Madoff affair, a gubernatorial impeachment on sale of senatorial seats, the collapse of our banks and Wall St. due to closed door shenanigans, and the near collapse of the world economic order, is beyond me. (Weren't the Madoff whistleblowers similarly ignored?)

-- SS


Anonymous said...

The deception of these HIT industry sponsored promo groups are no different than that of the Tobacco Institute claiming that cigarettes are safe; and the HIT manufacturers' behavior may be no different than that of the cigarette makers. They claim to be interested in manufacturing a safe device, a "typewriter for orders", but none have been tested for safety and efficacy and CSHIT has not any interest in how many people die from the devices it certifies...and they definitely die.

MedInformaticsMD said...

"Certifies" as a term may be the problem.

"Qualification" as having a certain feature set may be a better term.

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