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HIMSS: Part of the solution, or part of the problem?

May 26, 2009
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The Washington Post has published a couple of articles within the last few days shining a spotlight on the obvious influence that HIMSS exercised in drafting the HITECH Act and the HIT components of ARRA. The reports drew attention to the web of connections between HIMSS, CCHIT, CITL, the Administration, Congress and the ARRA.

The uninitiated wouldn’t be blamed for coming away with the impression that there was a conspiracy of powerful insiders who manipulated Congress into funneling billions to big healthcare IT vendors.

I think that a little perspective might come in handy.

For the sake of full disclosure, let me say up front that I am a member of HIMSS. Through the years I’ve volunteered for various committees and workgroups. I’ve tried to attend the national and state chapter meetings regularly, and consider HIMSS to be my most important professional organization.

With that established, the fact that I feel as strong an association with the organization as I do is a small piece of evidence contradicting the contention that HIMSS is a “vendor dominated” organization. From where I sit, it feels as if HIMSS has made a concerted effort to represent the interests of all the constituents that make up the HIT industry.

Does that include vendors? Sure. And I’m not so naïve as to think that the funding provided by the vendors isn’t a dominant portion of the organization’s budget.

But HIMSS constituents also include hospitals, the military, public health organizations, ambulatory healthcare organizations like mine, and a lot of individual members like me. I think that HIMSS leadership has recognized the necessity of navigating a middle road among these groups in order to maintain credibility with any of them.

HIMSS claims about 20,000 individual members. Most of them are individuals who have toiled in the backwater of HIT for years, battling constrained budgets, clueless administrators, reticent users, and immature systems. They’ve been motivated by faith in the promise of IT to improve the delivery of healthcare- not just in this country, but around the world. They’ve felt as if they were doing the Lord’s work.

20,000 members sounds like a lot, but trust me, the HIT world is a very small one. Most of us have been doing this for a while; we attend the same meetings, read the same articles, and share many of the same problems. There are considerably less than six degrees of separation between those of us who are tucked away in Appalachia and the Mark Leavitts of the world.

How does that 20,000 HIMSS members compare to other professional organizations?

Here, culled from their respective websites, are some examples…

Organization

Membership

American Library Association

67,000

Oncology Nursing Society

37,000

National Council of Teachers of Mathematics

100,000

American Water Works Association

57,000

As a small community, it’s not particularly surprising that the same people keep popping up doing different jobs.

Truth is there is a web of interrelationships- between customers and customers, vendors and vendors, vendors and customers, consultants and vendors, and any other permutations you’d like to define. I’ve often described some of the vendor relationships as “incestuous”. (Rather indelicately, now that I think about it.) Unfortunately, the adjective fits a lot of these other connections as well.

The term “lobbyist” is not a popular one these days. Does HIMSS participate in that enterprise? Yes they do. Are they masters of the Machiavellian art? I’m not convinced yet.

Anyone who took the time to read through the “Call to Action” that HIMSS published in December could not help but be impressed (or appalled, depending on your viewpoint) at the similarity to much of the language that made its way into the final versions of HITECH and ARRA. Most of it did not read to me like vendor boilerplate, however.

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I learned many years ago, that working with investigative journalists one must insist on being able to review and approve the final copy before being quoted. Reason: so many errors creep in and once in print it becomes gospel. Blogs are wonderful, but also could often benefit from independent vetting.

This is not to discredit reporters, I do want them to be around for a long, long time but I have learned that it is very difficult to accurately describe complex issues in a short period of time. The 80:20 rule applies!

That said, I feel HIMSS is attempting to focus on the issues that we have before us and will hopefully be of assistance in crafting useful definitions of policy, "meaningful use", what constitutes "certified" without being to narrow and enables substantial and hopefully comprehensive health information exchange. It would serve little purpose to move hospitals with their many silos of information to many hospitals forming islands of isolated information.

No journalist worthy of the title would allow a source to review a story before publication. Not sure who you've been dealing with but it is not standard practice in the profession.

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