Earlier this week, the newly appointed National Coordinator for Health IT Dr. B. Vindell Washington met with reporters over coffee and doughnuts to discuss his vision for the agency's future while acknowledging the current federal administration is in its twilight months.
Dr. Washington was promoted to the position after Dr. Karen DeSalvo, the fifth National Coordinator and current acting Assistant Secretary for Health at HHS, stepped down on August 12. Washington joined the federal government earlier this year as the principal deputy national coordinator.
In the announcement, HHS Secretary Sylvia Burwell stated Washington would "oversee implementation of the Federal Health IT Strategic Plan and the Nationwide Interoperability Roadmap to unlock digital health data and ensure it is widely accessible, usable, and transferable throughout the public and private sectors."
Washington highlighted three areas of focus for ONC's upcoming work on interoperability:
- National, federally recognized standards;
- Changes in how payments are received/made by working with CMS; and
- Cultural changes over sharing health data by working with HHS' Office for Civil Rights (perhaps the most important area of change, he noted).
He stated these areas all underscore the drivers on which to "lean in" and move the needle on sharing health information. Responding to questions over the recent study which found physicians spent just under one-half (49.2%) of their work day on EHR and administrative tasks, Washington stated he didn't know of many physicians that would want to go back to paper. He did acknowledge he believes we are still in an evolutionary phase when it comes to the ultimate usability of an electronic record and that efficiencies will follow as both companies and providers innovate.
This summer, the agency that 96% of all non-federal acute care hospitals in 2015 possessed a certified EHR. As Dr. Washington told Healthcare Dive in July, "You can't get true value until there's a high amount of information to share that's digital."
It's time to take pats on the back for EHR adoption and pivot to the sharing of health information, Washington told the reporters at the meeting this Monday. Information sharing is the right place for ONC at this time where EHR adoption is, he added.
He believes the work ONC is doing on information sharing is foundational. However, it's work that's important for delivery system reform as well as efforts surrounding longer bets such as the cancer moonshot and precision medicine. "Those are longer term efforts but the work in the short term is around increasing the flow of information" in addition to getting patients their electronic health information and the ability to send such information forward in ways they choose, Washington said.
Work surrounding these efforts include clarifying rules around HIPAA as the privacy and security rules could be better understood. Additional efforts will look toward building out use cases for information sharing. "Standards will always be a whiteboard exercise until they are in wide and deep use," Washington stated.
For the futurists in the audience, Washington discussed blockchain, which he noted is "not just for bitcoin" anymore. The agency put out a request for information on the technology and had received a shocking response (at least 77). ONC is interested in fostering emerging technologies, according to Washington, adding the agency has done its best not to get in the way of innovative activity for such technologies.
Information sharing has been a divisive topic in the health IT community for years. While work in this space will realistically be continuous, ONC's banner work for the remaining months of the current administration reads "Information Sharing" in bold lettering.