Yesterday we learned that the AAFP board decided not to join NAPCI. Like many family physicians, I don't understand why.
NAPCI, which was the brainchild of two family physicians, is an effort to unify the voices of primary care physicians. Despite the fact that primary care physicians provide the majority of medical care in theis country, hospital information technology needs have been the primary drivers of most of the standards and policies that healthcare IT vendors attend to. Without standards for primary care information technology – the mishmash that now exists will continue. To say that it is challenging for a primary care physicians to make good choices about buying an electronic health record in their office would be an understatement. Feature matrices, functional requirements, usability metrics .. etc etc etc .. it's all so complex and there is no unified message to the government on what primary care needs .. nor is there a unified message to the vendors.
But NAPCI – which now has been formally created – aims to change that, and I have high hopes for what it will accomplish. Yet when David Kibbe explained to me that "AAFP has decided not to join at this time." I realized that what seems so self-evident to most of us (that collaboration among the primary care specialities would be a good thing) is perhaps not so clear to some others.
Here comes the hard part: I can't help but wonder how much of the AAFP board's decision had to do with the messenger rather than the message. What does David Kibbe have against NAPCI? It's possible that in the context of his own efforts to play a role in the shaping of public policy and vendor policy through the AAFP's new Center, David wants to be the only such voice for primary care – rather than either sharing the podium with NAPCI or working through NAPCI.
Perhaps he'll weigh in at some point and help us understand that – but it's ironic that he was rebuffed by the other primacy care specialities when he approached them about joining the AAFP EHR project last Spring .. yet now when they have all agreed to work together through NAPCI – he turns his back on them. As a family physician and an AAFP member – I WANT the AAFP to join NAPCI – since I think that NAPCI is the best conduit for getting these groups to work together. Indeed, had David engaged NAPCI last spring, it's possible that the EHR project may have been more readily embraced.
Alan Zuckerman told me last night that the AAP has been surprised that David hasn't continued to engage them in the EHR project – and I've heard that SGIM and ACP have similar feelings.
It's all troubling because I do want the AAFP EHR project to flourish – and I suppose that working with other groups could be perceived as a potential roadblock in the path of moving the EHR project along swiftly.
Who knows. On my end — along with this well-kown genius – I'm going to begin lobbying AAFP to reconsider their decision. If you know an AAFP board member – or are active in your state Academy of Family Physicians – please do your best to send this message: