Various federal policy initiatives in the pipeline of the Office of the National Coordinator for Health Information Technology are intended to give consumers more simple access to their health information and help them become better in shopping for high-quality and less expensive care.
ONC is working to achieve the intent of Congress, as it intended in passing the 21st Century Cures Act, said Donald Rucker, MD, National Coordinator for Health Information Technology, in a keynote address at this week’s spring conference of the Workgroup for Electronic Data Interchange in Scottsdale, Ariz.
Rucker reviewed the three major provisions of the Cures Act that affect healthcare IT, saying his agency is working on determining how best to achieve the underlying goals that accompany them.
The 21st Century Cures Act primarily was enacted in December 2016 to authorize funding, mostly for the National Institutes of Health, for advanced research into treating complex diseases. However, ONC is working on how to implement IT provisions, which it hopes to finalize by the end of the year, Rucker said.
Information blocking provisions in the Cure Act were a Congressional response to testimony that it heard about challenges in enabling the free flow of medical information. “We’ve paid for the information in these electronic records systems many times over,” he said. “We want them electronically available.”
Rucker said he believes that continued efforts from ONC and other federal agencies will eventually eliminate practices that block access to information.
Secondly, ONC is working on the Trusted Exchange Framework and Common Agreement, another component to achieving the interoperable exchange of electronic health information. In the Cures Act, Congress directed ONC to “develop or support a trusted exchange framework, including a common agreement among health information networks nationally.”
ONC released a draft version of the Trusted Exchange Framework in January, outlining a common set of principles for trusted exchange and minimum terms and conditions for doing so, intended to bridge the gap between information systems and enable interoperability across disparate health information networks. Rucker says ONC has received more than 250 comments on the proposed regulation.
“These networks have to be more than one provider to one other provider,” he said. “For too long, our version of interoperability has been a provider-facing view of the world. That’s not what the view of modern networks are like. On the Internet today, we can do any number of transactions. For healthcare information networks, we want to think about them in the broader sense of the term.”
The third component of the Cures Act is the use of open application programming interfaces that will facilitate consumers’ access to their medical information, no matter where it lies in various healthcare organizations.
“We want some kind of uniform approach to this, that works with multiple vendors” of records systems, Rucker said. “The key part of this for Congress is that an open API needs to work without special effort. We want something that a typical programmer can build apps for a smartphone with tools that are readily available.”
The end game, Rucker said, is to give consumers the same access to information and managing capabilities that they experience in a range of other industries.
“The tool in everyone’s hand is the smartphone,” he adds. “Really, it is the logical place to synthesize that, looking at things from a patient’s point of view. Many industries have been transformed by the smartphone, and we should have that in healthcare. Congress was asked why is healthcare doing stuff that seems like its 20, 30, 40 or 50 years old?”
While provider organizations have done a lot to incorporate IT in day-to-day operations, there’s been only slight progress in getting information to consumers, which has more potential to transform the industry and reduce costs, Rucker said.
“We have done a lot of work on the back office, but we haven’t done anything like direct to the population because we haven’t had the tools we needed,” he concluded. “We’re looking for technology to now put consumers in charge of care. What’s most exciting to me is that it will be engaging all of us in our health.”
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