The White House on Friday called for the creation of a government-wide task force to strengthen coordination of healthcare IT among federal agencies that hold key roles in carrying out the administration's plans for a digital healthcare system.
The plan, described in a memo from Office of Management & Budget director Peter Orzsag and Health and Human Services secretary Kathleen Sebelius, sets up a way for agencies with heavy healthcare responsibilities to participate in planning healthcare IT projects set in motion by passage of the HITECH Act last year.
The memo was addressed to Defense Secretary Robert Gates, Veterans Affairs Secretary Gen. Erik Shinseki, Agriculture Secretary Tom Vilsack, Commerce Secretary Gary Locke, Social Security Commissioner Michael Astrue and Office of Personnel Management Director John Berry.
It asked the secretaries to choose a senior leader from their agencies to represent them on the task force and to send HHS their choices within five days.
The agencies have been hamstrung from participating in opportunities created under HITECH because of an ad hoc system of councils and advisory groups through which they have done business over the last several years, the HHS-OMB memo said.
Memo refers to 'legacy structure'
"This legacy structure is not a good fit for the new environment" that includes the ONC, two federal advisory committees, as well as "increased congressional engagement and attention from a diverse body of interests in the private and public sectors," the memo stated.
It added that "fragmentation of current federal health responsibilities, programs and coordinating mechanisms must be overcome to execute effectively the president's program."
To do so, it recommended "dissolving and restructuring the existing HIT inter-agency groups to form a government-wide Federal HIT Task Force."
David Blumenthal, MD, the national health IT coordinator, would chair the task force, according to the proposal. Vice chairs would be held by OMB's health program associate director, Keith Fontenot, White House chief information officer, Vivek Kundra and its chief technology officer, Aneesh Chopra.
HHS and OMB proposed the task force set up several working groups to focus on areas where it believes health IT coordination among the agencies is essential to the nationwide health IT adoption plan.
Suggestions for the sub-groups included the already-established Federal Health Architecture (FHA) community, which has been involved in Nationwide Health Information Network technology and interoperability planning.
More focus on population health
The memo recommended additional working groups be set up around the federal "Beacon Community" program, a series of community-based health information exchange test beds; the challenges of health information privacy and security; and one to work on interoperability between federal and commercial healthcare providers.
Working groups would be open to people from all federal agencies, giving them the opportunity to participate in specific health IT issues. The group will meet monthly or bi-weekly to start.
"We believe it imperative that policy and technical representation be integrated in these communities, so that the efforts of both can be fully informed and coordinated," said Sebelius and Orszag in their memo.
John Loonsk, MD, a former interoperability director at ONC, called the move "the latest in a series of efforts to appropriately engage federal agencies in national health IT efforts."
The challenge for the task force, he said, is two-fold: Fiirst, to coordinate the full force of federal participation in health nationally - over 40 percent of healthcare is touched by a federal agency; and second to enable federal agency input into HIT objectives and needs.
"There is necessarily a delicate balance here," said Loonsk, now chief medical officer for CGI Federal Inc., which offers business process and system integration services.
"While the majority of the HITECH Act is about non-federal provision of healthcare, many feel that population health needs like those represented by federal agencies need to be more prominently advanced by government or they may not be adequately addressed," he said.
This could include public health via the Centers for Disease Control and Prevention, health research by the National Institutes of Health and the protection of the food and drug system at the Food and Drug Administration, he added.
