The real question is.. how much the records will be sold for once they are inevitably breached. SSL is apparently broken, there isnt a credit card on the planet that isnt in some hackers database, so.. how much is a databse full of people's ailments, maybe even psychological histories, to say... insurance carriers.. banks loaning money.. employers.. the list goes on and on... Oh I know.. how about an online lookup of you offshore in the Isle of Man.. that would be pretty spiffy too..
Standards? phht.. the data will be in there.. its just waitin for the hackers..
The passage of the Obama Stimulus, and the presentation of a budget supporting comparative effectiveness, makes the question of health IT standards urgent.
What will they be and who will create them?
As of this writing, Nextgov writes, it appears that responsibility is headed toward the Office of the National Coordinator for Health Information Technology under Robert Kolodner and the Certification Commission for Healthcare Information Technology under Mark Leavitt (right).
This interpretation of the law is fair, but there is something of a shotgun wedding feel to all this. The preacher has already started the bit about “whoever has objections” and for the Obama Administration the clock is ticking.
How fast is it ticking? The Office of Management and Budget guidelines on handling the money are out but there is as yet no indication as to how the money should be spend regarding health IT.
The reason for concern is that CCHIT is, as Neil Versels notes, an industry group. It was created by the Healthcare Information Management Systems Society (HIMSS). Right after the inauguration CCHIT’s Leavitt asked for $20 billion, delivered essentially to the industry.
Do we want industry writing the nation’s health IT standards? CCHIT’s “standards” are, in fact, mainly approvals of whatever industry is doing. Many of these “standards” are proprietary.
The best open standards aren’t.
Right now the blogosphere is arguing about whether CCHIT is being “thrown under the bus,” and the group’s organizational background. But the key question, to me, is whether we want open standards or industry standards as the backbone of health IT.
Electronic Health Records (EHRs) can be extremely useful, not only at the point of care but in research. They let us create large groups of cohorts with any background or type of condition. No more relying on the old Framingham Heart Study. We can do it live, for any condition, based on any demographic cut you care to make.
But that is only possible if our health IT standards are open and royalty free. They won’t be unless this marriage of stimulus to CCHIT is halted before it’s consummated.
