ONC to Take a Softer Approach to HIE Governance

The Office of the National Coordinator for Health Information Technology is backing away from a proposal to establish a governance mechanism for the emerging Nationwide Health Information Network.

ONC issued a request for information in May and expressed its desire for common rules expressing technical, privacy and security, and business practice requirements to create a consistent trust baseline for stakeholders. “In the absence of national guidance, states and other private sector stakeholders/consortiums are beginning to develop state/consortium-unique and potentially conflicting governance approaches to electronic health information exchange,” ONC contended in an accompanying PowerPoint presentation.

But ONC got blow-back from stakeholders, National Coordinator Farzad Mostashari acknowledges in a blog entry posted on Sept. 7. “One concern we heard repeatedly was that the very act of beginning a regulatory process may actually slow the development of trusted exchange at a time when we cannot afford that.”

For instance, the eHealth Initiative coalition expressed concern that ONC was getting set to overregulate an activity--HIE--that is still evolving. The HIMSS Electronic Health Records Association in comments on the RFI called on the government to take a step back. Rather than the government developing an initial set of conditions for trusted exchange, called CTEs, the vendors suggested a public-private entity to address processes to establish CTEs.

ONC listened, Mostashari says. “Based on what we heard and our analysis of alternatives, we’ve decided not to continue with the formal rulemaking process at this time, and instead implement an approach that provides a means for defining and implementing nationwide trusted exchange with higher agility, and lower likelihood of regret.” His blog is available here.