Live from HiMSS08: Mike Leavitt touts local health exchanges

Today at HiMSS, audiences were treated to a speech from Mike Leavitt, head of almighty HHS. Leavitt, who comes across as far more relaxed and informal than you might expect from a guy with his authority, gave an extended pitch for the power of local relationships to build the health information exchange movement.

His take on building local trust comes from bitter experience, he said. As Governor of Utah, Leavitt told a packed auditorium, he found out quickly how protective people are of personal data when he proposed a plan to add a magnetic data-collection strip to driver's licenses. As he soon learned, his plan upset many citizens. "I learned that people have real worries about what happens if they don't have control of their information," he said.

To build health exchanges, providers will have to overcome even deeper privacy and security fears--and the only way to do so, in his view, is to build consumer confidence from the ground up. "The key here is trust, and trust is built locally," Leavitt said. "Trust is achieved one heart and one mind at a time--and they trust people they know. They intuitively don't trust distant bureaucracies."

For that reason, HHS is working to inspire local action. In fact, it's in the process of launching a new entity known as a "Chartered Value Exchange," a locally-based health information cooperative that exchanges not only clinical data, but also price and quality information. To date, HHS has named 14 quality and data sharing groups across the U.S. as CVEs. In return for agreeing to form the exchange, HHS is helping out by sharing relevant Medicare data.

Of course, cooperative spirit or no, HIEs won't work if they can't interconnect technically.  That is the point where the federal government should get involved, as a harmonizer and organizer of standards, Leavitt argued. Groups like the Certification Commission for Health Information Technology, which certifies EMRs, and the American Health Information Community, which promulgates standards, will both play a role in helping groups connect with each other, he noted.

Still, even where standards are concerned, local entities have a big role to play, Leavitt said. "There needs to be an organization in every community that can apply national standards in local ways," he said. "My mantra is 'National standards but local control.' "

All told, despite the obstacles that still exist to forming health information exchanges, Leavitt seems rather optimistic. "We're not as good at this as we need to become, but we're making progress, not just in technology but in sociology," he told the rapt audience. "I truly believe we're on the cusp of a revolutionary change in healthcare."

- Anne