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Tom Daschle Withdraws Nomination for HHS Secretary

Posted on February 3, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I haven’t really commented in the past about Tom Daschle’s appointment as HHS Secretary.  However, today it was announced that Tom Daschle has withdrawn his name from being HHS secretary.  I don’t know Tom Daschle that well, but from what I’ve read, it seems like Tom Daschle would have been more focused on implementing changes too health care not related to IT.  This guest post by Tom Daschle on the Huffington Post seems to indicate this feeling I have.

One thing is certain, it’s quite shameful that Tom Daschle could somehow have missed $128,203 in additional tax and $11,964 in interest.  Considering the amount of money Obama is planning on investing in EMR, I’m not sure I would have wanted Daschle involved in the process.

Of course, you have to wonder if there exists a politician that isn’t tainted in some serious way or another.  Whoever Obama appoints as HHS secretary, I hope it’s someone who will invest appropriately in HIT.  I also hope they’re as transparent and open as past HHS secretary Mike Leavitt was in his blog.

UPDATE:

I just found this interesting set of quotes and media put together by Alborg about Daschle and various special interests that he might have had.

I’m so happy that Daschle was forced to resign. He was one of the major HIMSS representatives on Obama’s team. From the HIIMSS website:

“HIMSS has arranged for members to personally add their support for Senator Tom Daschle to be confirmed as the next Secretary of the Department of Health and Human Services (HHS). “

In fact, he was paid off by HIMSS members, including speaking fees from Misys Healthcare Systems ($12,000) and GE Healthcare ($12,000) on 8/2008. Quote from article “Tax Cheat Daschle Favors Federal Reserve for Health“:

“GE Healthcare, one of several healthcare companies that paid Daschle tens of thousands of dollars to speak to their organizations, stands to profit if Daschle is confirmed and pursues Obama’s plan for more federal involvement in the health care field. Indeed, a part of the Obama plan, which is a specialty of GE Healthcare, is the electronic processing of medical records.”

Another quote from the recent media:

“While the tax cheating is getting some attention from the media, the $220,000 in speaking fees that Daschle collected from special interests in the health care field seems to be getting more coverage because of the fact, as noted by Kenneth P. Vogel of Politico.com, that many of these firms “stand to gain or lose millions of dollars from the work he would do once confirmed as secretary of Health and Human Services.” A front-page headline in the Washington Post, “Health Sector Enriched Daschle,” captures the obvious conflict of interest problem for the nominee. One of those firms is GE Healthcare, but chances are you won’t hear much about it from GE’s media properties…”

About Dashle’s book which includes HIT references:

“Daschle’s book, “Critical: What We Can Do About the Health Care Crisis,” published in early 2008, notes that “we are years, if not decades, behind European nations in harnessing health care information technology’s potential.” It calls for removing much health care policy-making from the political arena but states that at the same time the executive branch of the federal government should promote creation of an IT infrastructure for health information.”

The only question I still have is whether anyone exists that isn’t as bad or worse than Daschle.  At least maybe his replacement will know how to file his taxes.

HHS Secretary Mike Leavitt Blogs About EHR Adoption

Posted on May 26, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I came across the HHS Secretary Mike Leavitt’s blog. To be honest, I saw Mike Leavitt’s picture on the blog and I felt like I was meeting an old friend. No, I don’t really know Mike Leavitt from the next person on the street. We have never met before and the closest I’ve been to him is probably when I watched him pass by in numerous 24th of July parades in Utah. However, he was the governor of Utah for many of the years I lived in Utah and so I feel like I kind of know the man.

Reminiscing aside, I find Mike Leavitt’s blog completely captivating. He currently has been writing about his trip to China. For some reason I’ve always had an inner itch whenever I heard about China. I don’t know what it is, but I find the place completely fascinating. So, you can imagine my fascination with the HHS secretary’s interaction with the Chinese government. Plus, these posts about HHS and China give Mike a real personal quality that I find real and interesting.

Of course, I couldn’t begin to read the HHS Secretary’s blog without making sure to find some post about EHR or EMR. I quickly found a post entitled Value-Driven Health Care Interoperability which I think could more aptly be entitled “Electronic Health Records (EHR) Progress Report.” Of course, he is in government so that explains the title.

I’m grateful that the HHS Secretary is willing to engage the public in a discussion about EHR and EHR adoption, but unfortunately the post I found is so filled with political rhetoric. It sounds really good, but really has very little substance.

First, I’ll start with the good.

Three years ago, there were 200 vendors selling electronic health record systems but there was no assurance that the systems would ever be able to share privacy protected data in interoperable formats.

I think the concept of a certification for interoperability is good. It just makes sense that every EMR software vendor should be able to interact with another. Establishing a quality standard for this interoperability is valuable and even worth certifying.

Unfortunately, I think the HHS Secretary has been getting bad information when he says the following:

Since then, we have made remarkable progress.

An EHR standards process is now in place, and we are marching steadily towards interoperability. We created the CCHIT process to certify products using the national standards and it is functioning well. More than 75% of the products being sold today carry the certification.

Where to begin? First, Mike has suggested that there were 200 vendors selling EHR systems 3 years ago (It’s probably a few more than 200 EHR, but we’ll let this one slide). Mike asserts that “75% of the products being sold today carry the certification.” If that’s the case, then simple math tells us that there should be 150 certified EHR software, no?

If you look at the 2006 CCHIT Certified Ambulatory EHR list I count 92 EHR software products. Let’s see, that’s only 46% of EHR products that are certified. Plus, my count of 92 EHR counts some of the software multiple times since a number of the EHR software vendors certified multiple versions of their product. That sounds like less than 75% of EHR products sold to me.

Of course, Mike Leavitt certainly could say that 75% represents a percentage of actual products sold. Certainly the certified eMD’s has a lot more installs than any of the free open source EMR products out there. However, I think it’s a bit deceptive to say 200 EHR and then 75% of products sold if they aren’t the same thing.

I also love how it says 75% of products sold. I think we’re all aware of the outrageous failure rates of so many of the EHR products out there. It’s unfortunate that we don’t have a percentage of products installed. Then, you’d have a much better idea of how many doctor’s offices really have the possibility of interoperability.

Wait a minute! I was being extra generous above when I said that there were 92 Ambulatory EHR CCHIT certified. Why? Because it was 92 EHR certified with the 2006 CCHIT Certification. Correct me if I’m wrong, but I think that interoperability was taken out of the 2006 CCHIT Certification (along with the joke of the pediatric requirements). I’m pretty confident about this, because I work on one of the 2006 CCHIT Certified EHR and I have no way of sending a chart to another clinic other than manually going through the product and printing out the chart.

What does all this mean? That means that instead of 92 interoperable CCHIT certified EHR, there are only 31 EHR CCHIT certified in 2007. That represents 15.5% (not 75%) of the 200 EHR products on the market today are interoperable according to number of certified EHR.

I’m not really blaming Mike Leavitt for this. I’m sure him or his office was given a nice executive report with a bunch of data and they made it look as nice as possible. Reminds me a lot of what I call EMR sales miscommunications. Sometimes the data just gets lost in translation. Let’s just hope my trackback to Mike Leavitt’s blog gets read.

You thought I was done. Nope. Still plenty more to say and I’m just hitting the major points.

In addition, a National Health Information Network will start testing data exchange by the end of the year and go into production with real data transmission the year after.

This concept I really find intriguing. I look forward to seeing this go public and I’m glad it’s on the agenda. However, I fear that this isn’t more than political hyperbole. I’d love to see how they plan to address any of the following: unique identifier, the ultimate hacker’s health information paradise, economic model, motivational model and that’s just the list off the top of my head.

The primary reasons for low adoption rates among small practices are predictable: economics and the burden of change.

I’m glad you pointed out the obvious. If this was so obvious, then why did you support the implementation of a certification that costs so much money that EHR will inevitably raise the cost a small practice pays for an EHR? That doesn’t make much economic sense. Not to mention you missed what I think is the biggest factor in lack of implementation: fear. Not fear of change. Not fear of the expense. Certainly those are two major factors, but I believe that adoption rates by small practices are so low because most doctors have seen too many of their colleagues fail at implementing an EHR.

Let’s start waving the CCHIT certification flag again. Many will be willing to make the case that CCHIT certification helps supplant a doctor’s fear that their EHR implementation will fail. It may even supplant some fear, but what it doesn’t do is decrease the number of failed EHR implementations. It’s a problem I’ve discussed many times on this blog. Certifications don’t certify usability. They never have and never will.

I actually have a thought about what should have been done instead of CCHIT, but I think I’ll save that for a future post.

Thanks Mike for opening up the lines of communication with your blog. Now it will be interesting to see if Mike Leavitt and HHS have really embraced new social media and participate in the discussion they started. I’m certain that Mike’s blog is going to become one of my favorite reads.