The Kibbe/Leavitt Rumble in the High Tech Jungle!

May 27, 2009

Since CCHIT first came onto the scene back in 2006, we've usually read numerous partisan rants about the issues of HIT/CCHIT/HIMSS, with an occasional major clash among those of us mere mortals with a strong interest in the matter. Not often do we hear of a heated personal interchange involving two of the best-known experts in the field.

Since CCHIT first came onto the scene back in 2006, we've usually read numerous partisan rants about the issues of HIT/CCHIT/HIMSS, with an occasional major clash among those of us mere mortals with a strong interest in the matter. Not often do we hear of a heated personal interchange involving two of the best-known experts in the field.

This past week this is exactly what happened, beginning when the Healthcare Information and Management Systems Society (HIMSS) urged officials at the Health and Human Services (HHS) to recognize the Certification Commission for Healthcare Information Technology (CCHIT) as the de facto "certifying body" for determining which electronic health record systems (EHR) would be eligible to receive the funding if used in a "significant manner" under the recently passed American Recovery and Reinvestment Act of 2009 (ARRA). This wide-ranging stimulus law will be spending $20 Billion for Healthcare IT and $4.3 Billion for Smart Grid Technology. Many seem to desperately want a piece of the pie, but no entity more than HIMSS through its offspring, CCHIT.1

The hot debate started when David C. Kibbe, MD, a senior adviser to the American Academy of Family Physicians (AAFP), was quoted in The Washington Post2,3 questioning the appropriateness of the current federal taxpayer money funding of such an organization. Statements from Dr. Kibbe included:

• "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."

• "Even the appearance of a conflict of interest could poison the whole process."

What Dr. Kibbe was questioning was the association between HIMSS and CCHIT, including facts found through several sources:

1) The fact that Mark Leavitt, the former CMO at HIMSS, is now the Chairman of CCHIT.

2) According IRS documents, Leavitt was still on the HIMSS payroll through last year. HIMSS would then be reimbursed for his salary by CCHIT. HIMSS classifies him as "on leave from his position as HIMSS’ Chief Medical Officer while serving as Chair of CCHIT."

3) The Histalk link below goes deep into the "interesting expenses" incurred by CCHIT, including the fact that CCHIT had only four employees were richly paid, earning a total of $738,000.4

4) According to www.histalk2.com, up until 2/17/2009 CCHIT shared space in the same building as the founding vendor organization, AHIMA. They state: "CCHIT reported $866K transferred to AHIMA in a category that includes sharing of equipment, facilities, or employees. HIMSS received $196K for a category that includes performance of membership services."4

5) When CCHIT was first founded as a not-for-profit organization, their incorporation papers clearly stated that all profits were to be divided between the founding members. According to their 8/2006 minutes, they already planned on making a $1 million profit in the final six months of 2006.5

Today Mr. Leavitt, in an angry editorial response in The Health Care Blog6 wrote about his feelings about non-certified EMRs, his political enemies, and especially about Dr. Kibbe:

• About his political enemies—“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 [CCHIT] contributors.”

• About non-certified EMRs—“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.”

• About Dr. Kibbe—“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.”

All I can say to Mr. Leavitt is "GIVE ME A BREAK AND ADMIT THE OBVIOUS!" CCHIT is a HIMSS shill and represents a well-orchestrated attempt to corner the HIT market in the USA. Dr. Kibbe is a likable man, but what has found him an audience is that most people agree with his statements and position that it is improper for HIMSS to back CCHIT. The efforts by HIMSS will leave the HIT industry in the USA with a smaller playing field, with less competition, with less innovation, and with a massive increase in health care costs. HIMSS through CCHIT can lead to billions of dollars in HITECH money going to its select few biggest "enterprise" EHR vendor members.

My position is that were it not for the HHS and President Obama’s partnering with HIMSS/CCHIT, these entities would have long ago been found to be in criminal violation of the RICO Antiracketeering Act.7,8 Some of its members would have been found in violation of campaign contribution laws9; s.a. when Allscript's Glen Tullman who was nominated as Obama’s personal HIT consultant after personally donating $144,000 to President Obama in the two years preceding Obama’s election10,11. Many “enterprise” EHR CEOs and their respective companies that now are advising President Obama and Congress without the strong backing of big government, especially President Obama, would have been found long ago to be in violation the Hobbs Act (18 U.S.C.A. § 1951 [1994]) which makes it a felony for a public official to extort property under color of office. Trading campaign contributions for promises of official actions or inactions are prohibited under this act.12,13

But I'm just a mere mortal in this political battle over HIT. I solute Dr. Kibbe for his eloquent statements on CCHIT which will help improve the future outcome of our nation's HIT policies.

Al Borges

The HIT Realist

References:

1) ARRA Stimulus Package: $20 Billion for Healthcare IT, $4.3 Billion for Smart Grid Technology

2) Certifying Health IT: Let’s Set the (Electronic Health) Record Straight

3) HIMSS Calls for CCHIT To Certify EHR Systems; Critics Express Concern

4) More About CCHIT

5) CCHIT Documents of Interest - PDF1 & PDF2

6) Group Seeks Sway Over E-Records System; Health Association With Ties to Stimulus Lobbying Effort Pursues an Oversight Role

7) Does the Rico Act of 1970 Apply to CCHIT?

8) www.emrupdate.com/forums/p/11551/75582.aspx#75582

9) Federal Campaign Finance Laws

10) www.campaignmoney.com/political/contributions/glen-tullman.asp?cycle=08

11) http://fundrace.huffingtonpost.com/neighbors.php?type=emp&employer=ALLSCRIPTS

12) Hobbs Act

13) Hobbs Act