Can contractors be part of health IT reform?

Contractors got us into this mess, they sneer, with proprietary models and cost overruns.

John Loonsk (right) is trying to change that.

A longtime advocate for a national healthcare network while at the Department of Health and Human Services, Loonsk joined CGI Group, a major federal contractor based in Montreal in April, and wrote at Government Health IT this week as an advocate of standards-based reform.

But what kind of reform? Carefully-engineered reform, he says.

Now that there are funds, the national health IT agenda is no longer emphasizing proactive engineering. Instead, the focus is more narrowly on getting electronic medical records into practice settings, supporting the general idea of health information exchange, and hoping that the organic growth of the two solves the many needs of a nationwide infrastructure.

The administration should reconsider this plan.

Instead, he suggests, standards need to be engineered that all vendors would meet and connect to.

Doubtless, a contractor such as CGI Group could be hired to engineer those standards. But would that speed or slow the pace of health IT reform?

Loonsk argues his case based partly on the development of Internet standards. But those standards were negotiated, not imposed. And they developed organically along with the network, in an open, transparent process.

Of course, while the Internet standards door was always open, few other than engineers walked in for nearly a quarter century. The Web was overlain on a set of standards that were engineered, but also negotiated, and existed before it was spun.

Is that possible with health IT, given the large number of vendors already serving the market and the urgency of the task?