Federal budget cutting is all the rage now and there seems to be little doubt that the pain is coming, with health care absorbing more than its share.

Some of the health care cuts don't have to be painful. There still is plenty of waste, particularly with some funding that is already authorized: In less than five minutes, I found three recently awarded federal health I.T. contracts worth at least $15.3 million that simply don't seem necessary, and there's got to be plenty more.

Yeah, it's only $15.3 million, but hitting the brakes on these and other unnecessary contracts is the first tiny step in the federal government realizing it really, really has to decide what absolutely must be funded. I ask you if these contracts fall in that must-fund category:

* Consulting firm Accenture got $4.8 million to identify standards and specifications to facilitate health information exchange. The firm will work with the Office of the National Coordinator for HIT to develop and manage "use cases," or business scenarios, such as an electronic health records system handling patient requests for clinical summaries. Seriously? Don't we have standards development organizations, EHR and HIE vendors, and the HIT Policy and Standards Committees already working through such issues? What is Accenture going to learn or build that Medicity, Axolotl and other established HIE vendors don't already know and have? Both Accenture and ONC initially declined to disclose the value of the contract, which HealthCareInfoSecurity.com got and reported. That tells me they knew this money being spent couldn't be justified.

* Mathematica Policy Research Inc. received a $4.8 million contract to assist the Centers for Medicare and Medicaid Services in developing new clinical quality measures, directly reported from EHRs, for future stages of meaningful use. Again, where's the need? There are plenty of established clinical quality measures and there are plenty of vendors who would answer a phone call from CMS and explain which measures are doable in Stages 2 and 3. And there's the HIT Policy and Standards Committees, and a multitude of provider organizations that have ample expertise in these issues. What does Mathematica know that all these existing resources available to CMS don't?

* CGI Federal Inc. won a contract from ONC of up to five years--valued at $5.7 million in the first year alone--to continue development of the Connect open source, downloadable health information exchange software. This is the same software that the federal government already paid three companies to develop in 2008-2009, and then hoped a private organization would take over to manage. That finally happened this year when the Alembic Foundation released a private-labeled and enhanced version of Connect, called Aurion, that fixed 16 well-known bugs and better identifies HIE participants. And that was only their first shot at improvements. But right after Alembic Foundation did exactly what the feds hoped, ONC spent millions more on Connect. I just don't get it...


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