David Kibbe & Mark Leavitt : Openness vs. Opacity

Background information:

• The Certification Commission for Healthcare Information Technology (CCHIT) is currently in a monopolistic situation since it is, for the last few years, the only entity allowed to certify EHRs.
• The HITECH act of ARRA mentions specifically the requirement to use “certified” EHRs to be able to collect federal money to implement EHR at both doctor offices and hospitals. The next few months Dr. David Blumenthal will have to decide who will be entitled to do these certifications (Dr. Blumenthal is the National Coordinator for Health Information Technology. In his role he is charged with the implementation of HITECH). With at least $20 Bn. at stake, CCHIT will have enormous powers, if it remains a monopoly.
• Questions have been raised over time about the connection between CCHIT and HIMSS, the Health IT professional society, a vendor-sponsored organization.

This week the Healthcare Blog got on fire, thanks to an angry, vitriolic drive-by post from Dr. Mark Leavitt, former Secretary of the DHHS (innacurate) and current chair of CCHIT:

… I’m stunned by the level of dishonesty a few have stooped to in a desperate attempt to toss aside years of work by hundreds of public-spirited contributors.  Perhaps they want to bypass the challenge of supplying robust electronic health records and re-educating clinicians to use them meaningfully in transforming care, and just get unfettered access to some stimulus dough.

For months, I’ve been “turning the other cheek” to Dr. David Kibbe because I believe in devoting my energy to solving problems rather than to criticizing other people or worrying about what others think of me.  But his repeated use of falsehoods and innuendo to attack CCHIT have found an audience in the national media, reaching a level that can no longer be ignored.

David Kibbe, MD, an highly respected expert in EHRs and active supporter of patient-centered medicine responded:

“To clarify what I actually said, after a brief interview, quoted in the second of two articles in the Washington Post by Robert O’Harrow, Jr, a Pulitzer Prize finalist :

“One has to question whether or not a vendor-founded, -funded and -driven organization should have the exclusive right to determine what software will be bought by federal taxpayer dollars. It’s important that the people who determine how this money is spent are disinterested and unbiased . . . Even the appearance of a conflict of interest could poison the whole process.”

Raising questions and concerns like these does not reach the level of “falsehoods and innuendo.”  In my opinion, it is entirely appropriate to ask tough questions about whose interests are being served when $36 Billion of tax payers’ money is involved, and the future of health IT in the U.S. will be the result of certification.”

I am not the only one with these concerns. Many other health care and health IT professionals have raised legitimate questions about CCHIT and its practices, its relationship with HIMSS, and yet to date these have not been resolved. A response that attacks me personally and labels me a liar is far from adequate, and so the questions will remain.

The stakes are too high to simply look the other way.

Dr. Leavitt, nowhere to be found after shooting his arrow, has generated 58 comments, many asking where he disappeared after attacking an highly respected expert in EHR implementation.  Dr. Kibbe’s post has generated 30 posts, 10 of which are responses from David himself.

In other words, as expected, David Kibbe, one of the doctors most actively championing Participatory Medicine (although I think he doesn’t go far enough) has demonstrated once again the value of transparency, openness and conversation, while the defender of the monopolistic & paternalistic way of thinking could only respond to public questions with vitriol. Since both these individuals do represent the decision makers and opposite visions of governance, I’ll let you decide which governance method will offer better chances to succeed in reforming the incredibly opaque healthcare system.

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