Ex-CMS chief: Resolve health IT privacy, security issues

The federal government needs to lead the way in resolving the privacy and information security uncertainties surrounding health information technology, the former director of the Centers for Medicare and Medicaid Services told a Washington audience today.“Now is the time to really move forward on these privacy and security issues” that stand in the way of health IT progress, said Mark McClellan, who now directs a health care reform program at the Brookings Institution, a think tank.He mentioned the American Health Information Community, the high-level advisory committee at the Health and Human Services Department, as one possible forum for working through the issues, in addition to the HHS-sponsored Health IT Standards Panel.McClellan spoke at the annual conference of the eHealth Initiative, whose members were told earlier that unresolved privacy and security issues associated with health IT are bothering some members of Congress. The committee report accompanying the 2008 HHS appropriations bill in the House asked for a “privacy and security framework that will establish trust among consumers and users of electronic personal health information and will govern all efforts to advance electronic health information exchange.” The report specifies elements it wants to see in the framework, such as “allowing individuals to have a say in who and how their information is used” and maintaining data integrity.Ned McCulloch, manager of government and congressional relations at IBM, predicted that health IT legislation would at least come close to winning congressional approval next year. He said Rep. Anna Eshoo (D-Calif.) has introduced a bill in the House that resembles the Wired for Health Care Quality Act awaiting Senate action.Christine Bechtel, vice president for public policy and government relations at the eHealth Initiative, said more state governments are taking action on health IT because Congress has not done so. So far this year 15 state health IT bills have become law, she said.McClellan said he is working for “a high-value health care system that people won’t mind so much spending the money on.”To achieve quality, those involved in health care must agree on definitions of quality care and then measure their progress toward those goals, he said. This will require new and better health information systems, particularly for medical care. “There’s only so much you can do” with data collected for payment purposes, such as insurance claims, McClellan said.“Getting to a Nationwide Health Information Network isn’t going to be easy,” he said, “but I’m more optimistic now than I was in the past.”