Riding on an anti-regulation drive backed by the White House, groups unhappy with some actions by ONC are fighting to rein it in. President Trump has said that he would like to see two regulations killed for every new reg, and the groups seemingly see this as an opening.
One group challenging ONC activities is HealthIT Now, a coalition of providers, payers, employers and patient groups.
In a letter to HHS Secretary Tom Price, Health IT Now argues that ONC exceeded its authority last year, when it backed an oversight rule designed to boost the certification process by evaluating vendor interoperability capabilities.
The 2016 rule also holds health IT vendors accountable for technology flaws that could compromise patient safety, an approach which, HITN argues, steals a move from federal agencies such as the FDA. The group also contends that ONC has not been clear about its criteria for critiquing HIT solutions for safety problems.
Meanwhile, a group of medical societies and specialties is asking federal health officials to hold off on 2015 EHR certification requirements, which providers are expected to start using January 2018, for at least one year. The group notes that since ONC released its final 2015 Edition requirements, few vendors – in fact, just 54 of 3,700 products currently certified – have fully upgraded their systems.
Given this situation, rushing to deploy the latest certification requirements could create big problems, including a major disruption to medical practices’ business, the coalition argues.
If they’re forced to choose from the small number of systems which have upgraded their platforms, “physicians may be driven to switch vendors and utilize a system that is not suitable for their specialty or patient population,” the group said in a letter to CMS acting administrator Patrick Conway, MD, and acting ONC national coordinator Jon White, MD.
In addition to addressing certification concerns, there’s much the federal government can do to support health IT improvement, according to attendees at HIMSS17.
According to HITN, attendees would like policymakers to address interoperability, in part by reviewing Meaningful Use and the ONC Voluntary Certification programs; to focus on improving patient identification systems, and avoid imposing barriers to private market solutions; to clarify the role of the ONC in the marketplace; and to encourage the use of real-world evidence in healthcare and health IT deployment.
As I see it, these ideas veer between close-in detail and broad policy prescriptions, neither of which seem likely to have a big effect on their own.
On the one hand, while it might help to clarify ONC’s role, authority and process, the truth is that the health IT market isn’t living or dying on what it does. This is particularly the case given its revolving door leaders with too little time to do more than nudge the industry.
Meanwhile, it seems equally unlikely that the federal government will come up with generally-applicable policy prescriptions which can solve nasty problems like achieving health data interoperability and sorting out patient matching issues.
I’m not saying that government has no role in supporting the emergence of health IT solutions. In fact, I’m fairly confident that we won’t get anywhere without its assistance. However, until we have a more effective role for its involvement, government efforts aren’t likely to bear much fruit.
