Advisory board planned for health IT

HealthConnect Australia Legal Issues Report

The Department of Health and Human Services plans to form an American Health Information Community (AHIC) advisory committee to speed development and adoption of a nationwide electronic health record (EHR) system, HHS Secretary Mike Leavitt announced today at a health information technology summit in New York City.

Leavitt said health care IT is so essential to the country that he plans to lead AHIC, a 17-member public/private organization that will operate for up to five years under the Federal Advisory Committee Act.

Leavitt said AHIC will have five specific tasks, and EHR privacy and security paramount. The advisory board will also identify and make recommendations for health IT systems to provide immediate benefits for areas such as drug safety and lab results.

The new advisory panel will also help develop standards-based health IT systems and recommend a nationwide architecture that uses the Internet to securely exchange health care information. Once those tasks are completed, AHIC work to replace the advisory body with a private-sector committee within five years.

Leavitt told his audience at the Health Care Information and Management Systems Society meeting in New York that AHIC will "produce deliverables in periods of months."

HHS officials expect to issue requests for proposals June 7 to jump start development of a nationwide EHR system. The department seeks bids to create processes for setting data standards, certification and architecture for an Internet-based nationwide health information exchange. They also want a vendor to assess patient privacy and security policies.

HHS officials also plan to move forward on e-precribing, another e-health project, Leavitt said. A national rule is imminent, be he didn’t specify a date.

Ensuring the privacy and security of EHRs need to be the first issue addressed by AHIC, Leavitt said, reflecting widespread national concern over the security of personal information accessible via the Internet.

A survey released this February by the Privacy and American Business at the Center for Social and Legal Research showed that although 80 percent of online consumers go to health sites on the Web, they "express high concerns about security and privacy." About 69 percent of consumers polled in a Harris Interactive poll felt EHRs created threats to privacy, and 66 percent said they would be concerned about security breaches.

In Australia, which announced its national health IT strategy last week, strong opposition to EHRs quickly emerged because of privacy concerns. A report on the legal and privacy issues for Australia’s HealthConnect EHR systems states that an active system, which pushes patient information to health care providers, has greater legal liabilities than a passive system.

Australian Privacy Foundation officials said the EHR systems planned in New South Wales led to a change in the law's emphasis. Under current law, they said, New South Wales requires patients to consent to sharing health information. A new provision, however, would require patients to opt out of such sharing. Based on this change, the Australian Privacy Foundation has condemned the New South Wales EHR plan.

U.S. health care privacy advocates have urged a stronger opt-in provision, under which EHR information could only be shared if patients allow it. Health Privacy Project officials, in a letter to Dr. David Brailer the national coordinator for health IT, wrote that a patients must volunteer to participate in nationwide EHR systems, and they should have the ability to opt in or opt out of the system at any time.