Will Obama health IT committee give open source a chance?

Will Obama health IT committee give open source a chance?

Summary: Proprietary health IT has plenty of representatives here, but open source has several who might be termed persuadable. The future of open source in health IT is still within the power of the President to direct and control.


Where you stand depends on where you sit.

So where do members of the General Accounting Office's  Health Information Technology (HIT) Committee, described by GeekDoctor John Halamka as the new "Board of Directors" for Healthcare IT stand on open source?

(To the right, the headquarters of Epic Systems in Verona, Wisconsin, from G3 Technologies.)

Let's start with the "no" votes on the 13-member panel:

  1. Judith Faulkner, founder and CEO of Epic Systems. This is the proprietary vendor whose handling of Kaiser's EMR program was so problematic. Epic is already advertising on its Web site for stimulus contracts.
  2. Paul Tang, CMIO of the Palo Alto Medical Foundation. They're an Epic customer. Its PAMFOnline is based on Epic's MyChart.
  3. Charles Kennedy, vice president of Wellpoint. Remember that Ingenix database that was creating phony rates to cut reimbursement rates? Wellpoint is an Ingenix customer, and the AMA recently put them on the receiving end of legal papers over it.
  4. Marc Probst, CIO of Intermountain Healthcare. They committed to GE Healthcare's Centricity in 2005. Centricity is based on Microsoft Windows.
  5. Dr. Arthur Davidson, director of public health informatics at Denver Public Health. Davidson, like Kennedy and Tang, are on the board of the National eHealth InitiativeNational eHealth Collaborative, created under the Bush Administration under the name AHIC Successor.
  6. Neil Calman, who heads the Institute for Family Health in New York, is also an Epic customer.

Then let's go to the maybes, those whose backgrounds have little to do with software design and may go either way.

  1. Scott White, a technology director at Local 1199 of the Service Employees International Union (SEIU), which covers the northeast U.S.
  2. LaTanya Sweeney, who runs the Data Privacy Lab at Carnegie-Mellon and is also a visiting scholar at Harvard. The center's Web page makes no mention of either proprietary or open source solutions.
  3. David Lansky, CEO of the Pacific Business Group on Health, which seeks great analysis of medical data with an eye to reducing costs. I see him as a counterweight to Sweeney.
  4. Connie Delaney, dean of the University of Minnesota school of nursing, has written extensively on standards for nursing informatics.

Finally, those with reasons to be sympathetic to open source.

  1. Adam Clark, director of health policy at the Lance Armstrong Foundation. At the National Cancer Institute he helped develop the Clinical Proteomic Technology Assessment for Cancer, which is compatible with the NCI's open source caBIG project.
  2. Christine Bechtel, listed as being with the National Partnership for Women and Families, but had come from the eHealth Initiative, where she was vice president of public policy. The eHealth Initiative showed some sympathy to open source at its December conference.
  3. David Bates, of Brigham & Womens Hospital in Boston, has worked on using data to improve care and help patients evaluate care. He might be seen as the eyes and ears of ONCHIT David Blumenthal.

None of these can be called skeptics regarding health IT and its result buzzwords, like comparative effectiveness and evidence-based care. They are all advocates.

Just to add to the mix, both Congressional leaders and the Secretary of HHS have the power to appoint committee members. The President can also add to the list in order to represent federal agencies. (Someone from the VA, please.)

Three of the Congressional representatives were named yesterday, with that of Senate Minority Leader Mitch McConnell still pending. You also have those three HHS reps to come, and an unknown number of Presidential appointments.

The Congressional appointees:

  1. CEO Paul Egerman of eSription, a division of Nuance. Nuance recently acquired IBM's speech recognition technology. Egerman is an appointee of House Speaker Nancy Pelosi.
  2. Gayle Harrell, a member of the Florida House who recently railed against the stimulus bill's health IT provisions. She is an appointtee of House Minority Leader John Boehner.  She'll make meetings lively.
  3. Frank Nemec, a Nevada gastroenterologist who expressed himself as a skeptic of the Clinton Health Plan in 1994, appointed by Senate Majority Harry Reid.

Assuming the Congressional representatives represent their sponsors, a lot depends on whom incoming HHS Secretary Sibelius appoints, and the dynamics which develop within the group.

Proprietary health IT has plenty of representatives here, but open source has several who might be termed persuadable. The future of open source in health IT is still within the power of the President to direct and control.

Does he care about it?

Topics: Health, CXO, Enterprise Software, Open Source, Software, IT Employment

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  • Please someone SAVE us!

    Please will someone save us from our socialist gov...
    • The socialist canard no longer works

      That's why recent polls indicated Americans are
      becoming so skeptical of capitalism. When you
      call a mixed economy regulated by government
      "socialist," when you call Teddy Roosevelt
      (essentially) a socialist, the word loses its
      negative connotation and becomes a positive.
  • Pretty sad...

    Pretty sad when the only way open source can get anywhere in life is to hope that people are forced not to choose anything else.

    Pathetic, really...
    • I just want a fair shot

      A committee dominated entirely by one vendor,
      Epic, is in no one's best interests but Epic.
      Same with any other vendor.

      Same with open source, really.

      We need a broad based group that can at least
      balance its own interests and call for open
      • We told you so, ain't we

        ... that government can not create sound business b/c there's too much specially interest behind their decision making. Just another example big government doesn't work, and this Obamanomics will be a disaster.
        • Oh, pl-ease

          No one who supported the ruining of this nation
          by the ideology of the last Administration
          (including in the realm of healthcare IT) really
          has any call to complain at this point.

          You brought it on yourself.
        • The special interests are companies

          Guys & gals working (or owning) large companies going after
          their big salaries, huge bonuses and other benefits. (Can we
          say "corporate jets"?)

          The difficulty is going to have these people deliver knowledge
          and information without going after a greed grab. That's not
          big government - that's basic corporate greed - sort of reminds
          me of Grumpy, er, Cheney.

          Before worrying about "Obamanomics" it's wise to look at the
          increased costs during the W/Grumpy years. In the first 4
          years my health insurance programs went up $6,000+ a year
          and it continued to rise until I went on Medicare.

          Unless you're well into the 6 digit income level you'd better
          hope that Obama can at a minimum slow these increases.
          • "without going after a greed grab"???

            So your expectation of lower expense is not greedy? It seems only when you are not receiving the benefit that it becomes greedy.

            And you better join us in hoping Obama's socialist agendas to fail. His big spending spree will NOT lead to cost reduction in health care. Quite contrarily, he will bankrupt and produce a hyperinflation that will completely destroy this nation. I'm not talking about 1970's lightweight stagflation. I'm talking about Weimar Republic / Zimbabwe style hyperinflation. I'm talking adding zeros to your living expense. You think health care expense is high now? Wait until you see where it is at once hyperinflation erupts.
          • Risks in both directions

            Let me conclude this, if I can, by saying there
            are problems in what both sides say.

            Conservatives need to acknowledge there was a
            lot of corruption in the last 8 years. With no
            cops on the beat the criminals run riot --
            doesn't matter if we're talking squeegee guys or
            Harvard MBAs.

            Liberals need to acknowledge there are risks in
            increasing the deficit enormously from the
            present base. We do enjoy very low interest
            rates right now, but once the economy starts
            growing (and there's competition for investor
            dollars) they're going to go up. A lot.
            Competition does that.

            Fortunately the President seems aware of this,
            no matter how it discomfits liberals, and has a
            number of revenue-raising plans in mind. Carbon
            taxes. Sunsetting the Bush tax cuts. Social
            Security reform.

            The hope is that health care reform can get our
            total health care costs, as a nation, closer to
            the 10% or so other nations pay, down from 15%
            currently. That would help as well.

            But once we start growing again deficit
            reduction is essential. It's just that
            conservatives have no credibility on that
            question right now, given their record of the
            last 8 years.

            So as much as conservatives hate Obama now,
            liberals will probably hate him in 4 years.
      • So what do you consider fair?

        What do you consider fair?

        1. Removing the option to use non-OSS
        2. Allowing them to choose whatever the best solution for the particular situation is (be it proprietary or OSS)?

        As far as I know, #2 above has [b]always[/b] been the way it worked. When was to option to choose OSS ever artificially blocked by anyone?

        Apparently your definition of "fair" is to take away all options that involve proprietary software, whether it is the best solution for the job or not.

        That's like saying we should ban Formula 1 cars from the Grands Prix because we want to give the Ugos a fair shot. You know, to be "fair".

        Hmmm...k then....
        • Fair is #2

          The problem is that CCHIT, the authorizing agent
          for health IT, is controlled by HIMSS, which
          aggressively opposes open source at every turn.

          If you can't get your stuff certified people
          won't buy it. And the stimulus package insists
          on certification.

          Thus some way to certify open source for use in
          healthcare is necessary, either by changing
          CCHIT or by going around it.

          Then we can have fair competition.
          • Open to all platforms?

            It may be that the best open source has is to ensure there are
            laws and regulations that require all systems certified be accessed
            by all platforms.

            The BBC got caught with the pants down by breaking this law in
            the UK by delivering a Windows only version of some consumer
            services. They caught hell from all sides.

            Here there is only a need to hold up certification of systems that
            isolate themselves.
          • Need vs. desire

            There may only be a need to hold up
            certification of systems that isolate
            themselves, yet many isolated systems have been
            approved by CCHIT and no open source system has
            been -- yet.