Judy Faulkner, CEO of Epic and a member of the HIT Policy Committee, told other members of the committee and new National Coordinator Farzad Mostashari, M.D., she was concerned that forces promoting the PCAST vision also stood to gain from its adoption.
“What is showing up in blogs — I have seen and sometimes been told about this — is that we have to be careful of an apparent conflict of interests. That is if, in fact, the primary spokesperson for PCAST does have products that would benefit tremendously by this, do we get into — and I know we’re not supposed to judge — the uncomfortable position of an appearance of conflict of interests.”
Faulkner’s description of a “primary spokesperson” clearly referred to Microsoft’s Chief Research and Strategy Officer Craig Mundie, who Co-Chaired the PCAST HIT Working Group, which “participated in the preparation of an initial draft of the report.” Microsoft offers the HealthVault PHR platform. In December, Mundie both moderated and participated in panels at a PCAST Health Information Planning Meeting. (Relevant audio portions of the meeting can be found here: PCAST D; PCAST E)
Faulkner’s comments were made during the April 13 HIT Policy Committee after receiving a final presentation from its PCAST Report Workgroup, chaired by retired software entrepreneur Paul Egerman. (see the group’s PowerPoint presentation and Draft Letter)
In response, Egerman said, “It’s a great issue, an interesting issue,” before explaining he had received emails about the apparent conflict during his workgroup’s research. “For whatever reason, people were not comfortable talking about that issue.”
Egerman said the conflict of interests issue is why his workgroup choose to change the name of the proposal to the “New Exchange Architecture,” rather than the “PCAST Architecture.”
“We ought to say thank you to PCAST, but now it should be the ONC and HHS architecture, and we need to own it. It is not going to succeed if the people working on it feel imposed upon. They need to feel good about it and own it,” he said. “(That’s why we wanted to) take the PCAST name off it, to change who are the people advocating for it. Farzad and ONC should have to own this and change it however is appropriate to make it successful.”
After commenting that Egerman’s approach, and most of the PCAST report’s suggestions, were good, Faulkner continued, “The question is, if the PCAST report does push the need for everyone to use a PHR with the ability to have apps on it, there are limited number of those, and middleware with the ability to have apps on it, there are a limited number of those out there, then I think it is a challenge for ONC to figure out that apparent conflict of interests and what choices are there, what directions are there.”