Reductions in regulations are a mixed bag for HIT

Meeting a steady stream of rules is hard, but industry could use more fed guidance, says Liz Johnson.

The shift to the new administration in Washington has changed the approach for achieving regulatory guidance for healthcare information technology.

The number of regulations and rules descending from federal agencies is way down, says Liz Johnson, vice president and CIO of acute care hospitals and applied clinical informatics for Tenet Healthcare.

An executive order from President Donald Trump is part of the reason, said Johnson, chair of the board of trustees for the College of Healthcare Information Management Executives (CHIME). One of the many orders he has signed has required federal agencies to eliminate two regulations for every new one that’s created.

“So that’s working really well; we have no new regulations,” Johnson quipped at a session Thursday at the CHIME17 Fall CIO Forum in San Antonio. The idea behind the order was to ease regulatory burdens, which have been particularly crushing to providers in general and IT operations in particular.

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“All the rules we’ve faced have created more overhead for us, and we really can’t take much more,” she said.

Budget constraints also are limiting the bandwidth of federal agencies such as the Office of the National Coordinator for Health Information Technology, which saw its Fiscal Year 2018 budget slashed by 39 percent from the $60 million it received in FY 2017.

“That’s clearly going to indicate a change in ONC’s scope,” Johnson said.

For example, in testimony before a Congressional panel this week, Jon White, MD, deputy national coordinator for health IT, noted that ONC would not be able to meet one of the requirements of the Cures Act, a provision that calls for a transparent process to develop criteria as part of an “EHR Reporting Program” for certified health IT.

Other challenges await the health IT industry as the Food and Drug Administration is relaxing its oversight of mobile apps; Johnson contends that providers could bear the brunt of the risk for data breaches involving apps, even as it’s facing increasing pressure to give consumers access to more healthcare information through use of apps.

“Washington is still very divided—today, we don’t even see solidarity within the parties,” she said. “We need them to stabilize so we know what they’re going to do so we can move forward. This has impacted our ability to predict what’s going to happen and thus what we need to do.”

Recent pronouncements out of Washington have been good for the industry, Johnson said, highlighting the decision to not require providers to meet Stage 3 of the Meaningful Use Program in 2018, and setting 90 day reporting periods for the year instead of reporting on the entire 365 days of the year.

CHIME advocacy staff and organizational leaders will be looking for further guidance on the recently announced plan by CMS to move to a program involving meaningful measures. While no details have been released, it appears the approach could reduce the regulatory burden on providers while increasing the utility of the measures involved.

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