A federal committee that includes a major donor to President Obama and whose company stands to profit from the panel's recommendations holds in its hands the future of health information technology policy.
Judith Faulkner, founder and CEO of Epic Systems Corp., secured a seat on a panel charged with recommending how $19 billion in stimulus money dedicated to health IT be spent, despite opposing a key administration position on the issue.
Faulkner and her company oppose the president's vision for health IT, but Epic employees are massive Democratic donors. They've given nearly $300,000 to Democrats since 2006, according to the Center for Responsive Politics.
That may help explain both Faulkner's appointment to the 13-member Health Information Technology Policy Committee as a representative for health IT vendors, and the accolades her company regularly enjoys from prominent Democrats.
Obama has long pushed for "interoperable" health information technology, including digitized medical records that can be shared across platforms, regardless of who develops the underlying software.
A December 2010 report on the implementation of health IT from the President's Council of Advisors on Science and Technology described the ideal system as "interoperable and intercommunicating, so that a single authorized query can locate a patient's records."
Epic declined to comment on the appointment or the company's position on interoperability. Linda Kohn, a spokeswoman for the Government Accountability Office, which handled appointments to the panel, said that views on interoperability -- or any other specific health IT issue -- did not factor into its decisions. In fact, she said there were no specific criteria used to screen applicants.
All potential committee members were screened by two GAO employees, who then passed remaining nominations up to the comptroller general's office. Kohn would not say who nominated Faulkner, who sat on the two-member screening panel, or whether there were other nominees for the committee's health IT vendor position.
Faulkner isn't the first Democratic donor to receive favorable treatment from the Obama administration. An investigation by iWatch News found that Obama had given favorable treatment -- including positions in his administration and lucrative federal contracts -- to scores of his biggest donors.
Faulkner's appointment is notable, though, in that it runs counter to Obama's goal of multivendor interoperability.
Faulkner told Bloomberg News in 2009 that sharing medical records "doesn't work when you mix and match vendors. ... It has to be one system, or it can be dangerous for patients."
Epic's website touts its work with interoperable software, but all such systems are made by Epic, meaning they are only interoperable if every provider uses Epic's software.
Glen Tullman, CEO of health IT company Allscripts, recently called Epic "the least-connected system of any out there." He added, "The only people in the market who are fighting connectivity are Epic."
Still, Epic not only represents vendors on the health IT policy committee but is frequently invoked (implicitly, for the most part) by Obama appointees lauding health IT's potential.
Obama himself has mentioned Geisinger Health System, Kaiser Permanente, the Cleveland Clinic and the Mayo Clinic -- all of which use Epic software -- as "examples of how we can make the entire health care system more efficient."
He specifically lauded health IT as a cost-saving measure: "They've got health information technologies so that when you take a test, it actually gets forwarded to the next doctor and the next doctor and to the nurse and the pharmacist, so that there aren't any errors."
Only a few days before, Obama claimed that the Cleveland Clinic "has one of the best health information technology systems in the country." That system was made by Epic.
Since Obama's accolades and Faulkner's appointment to the policy committee, Epic has received a $14 million contract to implement new electronic medical record software for the Coast Guard. It is also vying for a contract for a massive expansion of the Veterans Administration's electronic medical records.
The VA is adamant that the resulting system be open source and interoperable, but five members of Wisconsin's congressional delegation recently wrote a letter to the VA's chief information officer stressing the importance of single-vendor electronic health record systems -- i.e., the type that Epic provides.
"While multi-vendor EHRs were common in the past," the letter states, in a near perfect reflection of Faulkner's position, "patient safety, workflow efficiency, and other concerns have caused the industry to move away from this model."
One of the signers, Democratic Rep. Tammy Baldwin, received $27,800 from Faulkner, including $10,000 in contributions to her PAC.
If Epic gets that contract -- and once again wins approval from the administration despite a massive divergence in views on interoperability -- it will be difficult to see anything but political factors at play.
Lachlan Markay is an investigative writer with the Heritage Foundation's Center for Media and Public Policy.
First appeared in The Examiner