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Washington Debrief: Senate Funding Report Tells ONC to Focus on Interoperability

July 28, 2014
by Jeff Smith, Senior Director of Federal Affairs
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Jeff Smith, Senior Director of Federal Affairs

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Senate Funding Report Tells ONC to Focus on Interoperability, End ‘Information Blocking’

Key Takeaway: The Senate Appropriations Committee released draft spending legislation and report language for the Department of Health and Human Services for Fiscal Year 2015, specifying funding priorities at the Office of the National Coordinator for Health IT (ONC), including information sharing and interoperability.

Why it Matters: In recent comments, CHIME asked ONC to reconsider the role and composition of its certification program to address patient safety risks and interoperability. The language in the report released by Senate Democrats accompanying the FY15 HHS funding bill reflects a similar frustration, one that previously had only been voiced by Senate Republicans, attacking the lack of interoperability in the health IT industry and the need to revisit the certification program.

Regarding “information blocking,” the Committee asked ONC to report on how many organizations are involved in the “information blocking problem.” The Committee suggested that ONC should use its authority to certify only those products that clearly meet current meaningful use program standards and also do not impede health information exchange. The report language calls on ONC to decertify products that proactively block the sharing of information and thus make this technology less valuable and more burdensome for eligible hospitals and eligible providers to use.

The appropriators also asked the Health IT Policy Committee to submit a report within a year of enactment of the legislation to the Senate Committees on Appropriations and Health, Education Labor and Pensions (HELP), detailing the challenges and barriers to interoperability. Lastly, the Committee asked for further information on the role of certification in advancing or hindering interoperability across various providers. The report language is not legally binding, but agencies generally follow the Committee’s recommendations. The Committee set ONC’s FY15 funding level at $61,474,000, an increase of about 2 percent from the $60,325,000 they received in 2014.

The current political climate suggests that it is unlikely any of the FY15 spending bills will advance before the November elections. Congressional leadership has stated an intention to pass a Continuing Resolution (CR) as a temporary spending measure to fund the government beyond Sept. 30, 2014.


Hearings Focus on Privacy Policy, Big Data in Healthcare

Key Takeaway: Lawmakers and regulators held hearings last week to better understand what barriers inhibit the flow of “big” health data for research and similar purposes.

Why it Matters: Increasingly, stakeholders are openly discussing the shortcomings of federal privacy laws and the patchwork of state laws that dictate when large amounts of health data can be used for research purposes. Continued pressure may force lawmakers to address gaps in divisive privacy policy.

Several stakeholders, including providers, researchers and technologists, have told policymakers in recent weeks that changes must be made to privacy laws to ensure that the benefits of big data are accrued in healthcare. During a pair of hearings – one held by the House Energy & Commerce Committee and the other by HHS’s Advisory Committee on Human Research Protections – policymakers were told current regulations make it difficult to utilize large amounts of health data to improve care. Clinical and research professionals said the lines between quality improvement efforts and health research are blurring and that consent laws are outdated. Testimony given during the Energy & Commerce hearing focused on the need to update and modify HIPAA’s authorization components, and amend federal “data use agreement” restrictions. Officials discussing the issue at the HHS advisory meeting focused on patient consent and what data uses should require patients to opt in vs. opt out of sharing their data.

It is not entirely clear how much additional pressure will be required for HHS and Congress to re-examine privacy laws, but the debate will likely continue well into the future.

ONC Seeks Input on Certification Test Methods

Key Takeaway: ONC’s Standards and Interoperability Framework has launched an Open Test Method Development Pilot Program to encourage stakeholder engagement in the health IT certification program.

Why it Matters: In recent comments to ONC, CHIME argued for improved testing, as part of certification, to ensure that certified EHR modules can interoperate with one another. This initiative will give participants a chance to improve the certification process by building tests based on input from technology developers and providers who use certified EHR technology.

The Open Test Method Development Pilot Program enables stakeholders to contribute their expertise on test methods, including test procedures, test data and test tools, that could be used by accredited testing laboratories for health IT testing. The pilot program is limited to two 2014 Edition EHR certification criteria, which eventually will be evaluated for feasibility, efficiency and scalability relative to future EHR editions. On Aug. 4, 2014, ONC will post the two certification criteria chosen for the open test method development pilot program. ONC hopes to complete the development of two test methods by Oct. 31, 2014.