At the Office for National Coordinator for Health IT (ONC) Town Hall on the official opening day of HIMSS17, the federal agency revealed its highest priorities, with the recently passed 21st Century Cures Act topping the list.
The Town Hall at HIMSS17 drew significant interest, and with it a packed room of attendees who lined up to ask questions as it related to federal health IT policy. Several members of the ONC staff joined White on stage and gave their specific department updates, but as Acting National Coordinator for Health IT Jon White, M.D., noted, the health IT arm of the federal government wouldn't disclose much about the new administration's top priorities, with two exceptions: reducing the burden that technology puts on doctors, and achieving widespread interoperability. "And those are two [priorities] that I am good with," said White who has taken over the National Coordinator post from Vindell Washington, M.D., an Obama appointee. Washington had a short run as National Coordinator, serving for just five months following Dr. Karen DeSalvo’s full-time move to HHS.
Nonetheless, White did also say that the health IT provisions of the Cures Act "were the culmination of [two] years of very active dialogue. We had five healthcare committee hearings last year on health IT that were very rigorous. It's [perhaps] the highest priority of ONC."
Indeed, some of the core health IT components of the legislation, as read in the “Title IV—Delivery” section of the law, include encouraging interoperability of electronic health records (EHRs) and patient access to health data, discouraging information blocking, reducing physician documentation burden, as well as creating a reporting system on EHR usability. Specifically regarding information blocking, developers, exchanges, and networks found to have engaged in data blocking and who have submitted a false attestation would be subject to civil monetary penalties not to exceed $1 million per violation, per the law.
When asked by a member of the health IT trade press if ONC's work on the health IT provisions that Cures calls for the agency to implement will have to wait for a new National Coordinator to be named, White said, "I will welcome with open arms the next National Coordinator, and we will be delighted to bring [new staff] up to speed." He added, "Cures is a thoughtful law that has important provisions. We have been working closely with the new political leadership and new [HHS] Secretary's office," then adding that waiting for Sec. Tom Price's recent confirmation was a necessity.
What's more, White pointed that inside the Cures law, Title IV, where the health IT provisions are outlined, divides responsibilities among ONC, the HHS Secretary, as well as some elements that are shared between the agencies and the Office for Civil Rights (OCR). "If you read the law, there are [parts] that say, 'ONC shall' and then [parts] that say 'the [HHS] Secretary shall,' so some of that is ours and some of it is shared," said White. "We are talking with CMS, OCR [and others] to figure all of that out, but we need executive sponsorship [from White House leadership]. We are still waiting; it's been just a week since Sec. Price was confirmed, and a month since President Trump's inauguration," White noted.
White further noted that Cures authorizes a lot in terms of health IT overseeing, but authorization isn't the same as appropriation. "So we are operating under a continuing resolution, meaning that you continue things you are already doing," he said. This includes the combining of ONC's two health IT advisory committees into one, as well as working on its Trust Framework. But for the rest of it, said White, seemingly referring to the bulk of the health IT provisions in Cures, "are newer and may need new appropriations."