A Debate (And A Response) You Would Never See Happen Here! More is the Pity!

The following appeared a few days before Christmas.

Gov't. groups keep quiet on closed-door meetings

By Joseph Conn / HITS staff writer

Posted: December 23, 2009 - 11:00 am ET

HHS and the Obama administration's Office of Science and Technology Policy are standing firm about a recent series of closed-door meetings on health IT policy.

Either they are not responding to requests for citations of legal authority for closing the meetings, or, in one instance, saying the law didn't require the meeting to be open, but not providing the specific reason it was closed.

Neither have responded to the question of whether, in light of President Barack Obama's recent order to foster openness and transparency in government, it was appropriate to close the meetings even if they had legal authority to do so.

Meanwhile, a healthcare information technology professional and disgruntled federal IT policy observer said he has filed a request under the federal Freedom of Information Act for copies of agendas and minutes of the most recent meetings.

“I'm a stickler for following the rules,” said Brian Ahier, a health IT professional, IT blogger and a member of the city council in the Dalles, Ore., who as a public official routinely complies with what he describes as a strict state open-door law. Ahier has written and posted protests about the closed-door sessions.

“With billions of dollars of stimulus funds on the line, and major stakeholders represented on these committees and work groups, it is imperative to avoid even a whiff of impropriety,” Ahier wrote.

I'm really concerned that the spirit of the open government directive is being violated here,” Ahier said in a telephone interview.

At issue is an interpretation of the Federal Advisory Committee Act, or FACA, and the applicability of federal open-door rules to the work groups and subcommittees of FACA advisory panels.

For decades, the government has relied on the advice of committees of subject-matter experts and advocates. Today, the government sponsors more than 1,000 FACA advisory panels, according to histories of their organization and explanations of their operations at two Web sites maintained by the Committee Management Secretariat at the General Services Administration.

The secretariat provides training and guidance for various government officials on setting up and running FACA panels. The FACA requires that for most advisory committee meetings public notice and the agenda of a meeting be published in advance and the meetings themselves be held in public. If a meeting isn't open, the notice should cite one of 10 specific “sunshine law” exceptions under which meetings appropriately can be closed, according to Kennett Fussell, deputy director of the secretariat.

Vastly more here (free registration required):

http://www.modernhealthcare.com/article/20091223/REG/312239986

This was then followed up here:

Blumenthal pledges openness in HIT discussions

By Mary Mosquera

Wednesday, December 23, 2009

The Office of the National Coordinator for Health IT will open to the public the meetings of small workgroups within its advisory Health IT Policy and Standards committees starting Jan. 1.

“We want to do more to bring you into the conversation,” said Dr. David Blumenthal, the national health IT coordinator, in a blog post http://healthit.hhs.gov/blog/onc/ today to the health IT community.

Currently, the work group gatherings, which concentrate on specific issues in health IT, such as security and privacy and the nationwide health information network, are not always public.

Some publications and bloggers have called out the ONC for not being open enough.

“I am committed to open and transparent discussion of issues critical to achieving ONC’s goals of promoting adoption and meaningful use of health information technology,” Blumenthal wrote.

More here:

http://govhealthit.com/newsitem.aspx?nid=72797

Wouldn’t it be nice if there were a ‘sunshine law’ in Australia so we could all contribute to seeking some better, more clinically relevant and more practical ways forward here.

It is also evidence of the quality of the US governance of Health IT that Dr. David Blumenthal, the national health IT coordinator quickly made sure openness was maximised. I wonder will something line that ever happen with NEHTA?

The following seems to be sort of strategic shift that could help in Australia - rather than having all those mega clinician unfriendly implementations we seem to be blest with.

DH shifts IT from 'replace' to 'connect'

22 Dec 2009

NHS informatics in England will move from a “replace all” to “connect all” philosophy, the Department of Health has announced.

Informatics planning guidance for 2010-11 says an updated strategic direction for informatics will be developed over the coming months to reflect the change in emphasis.

The guidance says a new direction has also been agreed for the National Programme for IT in the NHS, which will give the NHS more involvement in decision-making on the scope and timing of implementations.

It also sets out a series of expectations that local community operating plans for 2010-11 must deliver. The guidance says these have updated from previous years because compliant software is now more widely available. The expectations include:

• Risk-assessed plans of how and when each of the Clinical 5 will be used by all the clinicians in a local health community and whether the systems will be procured via local service providers or the Additional Supply Capability and Capacity framework.

• A timeline for the creation of Summary Care Records at all SCR-complaint GP practices in the 2010-11 financial year.

• Plans to complete NHS COnnecting for Health preparations for the implementation of Release 2 of the Electronic Prescription Service.

• Plans demonstrating how digital capabilities are being actively developed to support improved patient experience, such as promoting the use of NHS Choices and providing tools to help clinicians and managers use feedback to improve quality.

The informatics planning guidance reflects the themes of the Operating Framework for the NHS In England 2010-11, which was issued by NHS chief executive David Nicholson last week.

More here:

http://www.ehiprimarycare.com/news/5495/dh_shifts_it_from_%27replace%27_to_%27connect%27

The key issue I see is that if you have bureaucrats beavering away, essentially in secret, you are doomed to get what we are getting.

If the decision making and consultation processes could be more transparent, open, consultative and responsive we might do a good deal better.

More New Year dreaming I guess.

David.