Health Data Management reports that: “A registered nurse in Durham, N.H., has filed a civil suit against three officials of the Obama Administration alleging the American Recovery and Reinvestment Act’s health information technology provisions unconstitutionally violate the HIPAA privacy rule, Privacy Act and Federal Common Law…”

Scot Silverstein has a must-read article reacting to the recent Washington Post article on Health IT lobbying: “…A lot of voices were left out of that trade group’s lobbying. That trade group’s massive conflicts of interest also seem to have blinded it to the longstanding concerns of experts in medical informatics that current approaches to health IT are insufficient and may impair healthcare quality initiatives (let’s be frank about what that really means – it means patient harm)…”

“How an Industry Lobby Scored a Swift, Unexpected Victory by Channeling Billions to Electronic Records” The Washington Post has an eye-opening article on what really happened with the Health IT stimulus bill. It looks like Buckminister Fuller’s GRUNCH of Giants is alive and well. I now see the connection between HIMSS, Partners and AMIA. I’ve often wondered why AMIA has always been dominated by the Northeast/Massachutsetts crowd, why things like the Linux Medical News Freedom Award has been given such a cold reception year after year, and why AMIA leaders seem to hold such contradictory positions to AMIA’s mission. Things like government intervention bad (but we lobbied for it secretly), taxpayer money good, proprietary vendors good, physicians and taxpayers in perpetual financial servitude good. Now I know. That the health IT in the stimulus bill isn’t a social experiment at best (I’m being charitable) or simply a wealth transfer to proprietary vendors and government at worst is evident. Prove me wrong.

Fred Trotter writes: I have recently been asked to testify at the NCVHS hearings on meaningful use (see forwarded message below). This is very likely because I have been working as a representative of the FOSS community with CCHIT to resolve the basic incompatibility with current CCHIT certification and FOSS EHR systems. For a decent summary you can read the CCHIT category on my blog or read some of the mainstream blogs: slashdot and ZDnet

Now I will be asked to testify on what ‘Meaningful Use’ of EHR systems means from a FOSS perspective. I am having discussions on what I should cover on both Hardhats (VistA community) and OpenHealth (larger FOSS community). Feel free to email me off-line (fred dot trotter at gmail dot com) or simply reply to this thread, with your thoughts.

According to this press release: “Washington, D.C. —Senator John D. (Jay) Rockefeller IV today introduced legislation that will facilitate nationwide adoption of electronic health records, particularly among small, rural providers. The Health Information Technology Public Utility Act of 2009 will build upon the successful use of “open source” electronic health records by the Department of Veterans Affairs as well as the “open source exchange model,” which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative…”

opensourcereleasefeed has a interview with Fred Trotter on CCHIT certification/HIMSS and the new Health IT landscape with respect to Free/Open Source:

“If you care about FOSS generally, I need you to show up at the HIMSS meeting. If you care about FOSS in Health IT, it is especially important that you be there. I believe that FOSS is the only real hope for untangling the mess that is Health IT. If you find any of these arguments compelling, show up. If you cannot show up, call in. If you cannot call in, then comment on the openhealth mailing list. (http://tech.groups.yahoo.com/group/openhealth/)…HIMSS on the other hand, has consistently refused to consider FOSS players as real constituents. They are essentially a proprietary vendor lobby on par with the Business Software Alliance. My blog post points to some very specific examples of this….I can tell you that in Health IT, FOSS is the future.”

http://money.cnn.com/2009/02/25/news/economy/healthcare_spend/index.htm?postversion=2009022517

Health care overhaul: $646 billion

February 25, 2009: 5:12 PM ET
WASHINGTON (CNN) — Two White House officials told CNN Wednesday that the proposed budget to be released Thursday will include a $646 billion health care “reserve fund,” which is intended to help pay to overhaul the nation’s health care system.

One of the officials said the administration sees health care as key to the nation’s fiscal health and called the fund a down payment on President Barack Obama’s effort to reform health care.

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Here is a series of crucial but un-answered questions in the Health IT provisions of the recent American Recovery and Reinvestment Act of 2009:

1. If Health IT training is increased on a large scale, what will be the actual, working system that they train on?
2. How effective can large-scale education and training be when the systems in place in actual practice are very different than training
   ones?

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What if Mark could be convinced to literally fund open source (CCHIT ceritifcation fees, for example)? – Ed Dodds

Its easy to write about what the government or other people should do with our/their money. It’s harder to come up with a course of action that I can undertake on my own that possibly, somehow could make a difference. My first inclination is always to try to look “for the next big thing”. But the next big thing is just that, next. Its not now. Its Venture Capital. Its not self funding, renewal capital.

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Jeff Soble, Neil Cowles, and Edmund Billings have a response reproduced after the break to HIMSS “Call to Action”. This is a sobering look at the American Recovery and Reinvestment Act of 2009 which looks poised to result in the demise of real competition, medical data in the hands of a cartel or monopoly for a few wealthy corporations, loss of privacy and the loss of the physician as the traditional custodian of medical data. Item 3 is salient: “CCHIT works to the benefit of a small number of large EMR vendors that can command a high price from the relatively small segment of the market able to currently afford their products. It is essentially anti-competitive, and establishes a major barrier to entry by new vendors and open source projects (where the majority of innovation will take place).”

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