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Coalition Seeks Changes to ONC Role in Interoperability

Health IT Now is critical of ONC's work to improve interoperability and reduce regulatory burden through health IT certification.

ONC oversight of health IT interoperability

Source: Thinkstock

By Kyle Murphy, PhD

- A coalition of organizations representing patients, payers, providers, and health IT developers is calling on HHS to review and limit the regulatory powers of ONC pursuant to provisions of MACRA and the 21st Century Cures Act.

In a recent letter to Secretary Tom Price, MD, Health IT Now made recommendations to the federal agency, a majority of which focus on reducing or redirecting the responsibilities of ONC related to promoting interoperability, preventing information blocking, and certifying health IT systems.

The coalition — which includes Aetna, athenahealth, McKesson, and Oracle — is largely critical of the ONC’s regulatory actions over the previous years and advocating for a reduction in the federal agency’s regulatory authority in the years to come.

“Recent actions taken by ONC not only overstep statutory authority, but show dedication to mission creep rather than the core directive from Congress: achieve interoperability and do so quickly,” wrote Health IT Now Executive Director Joel White.

Particularly, the coalition seeks the rescinding of the ONC Enhanced Oversight and Accountability final rule, which it contends overlaps with FDA’s oversight of health IT-related threats to patient safety and runs counter to the aims of the 21st Century Cures Act. Likewise, the letter calls for a “thorough review of ONC’s role in the marketplace.”

Also on the regulatory front, Health IT Now highlights the need for ONC to make progress supporting MACRA implementation as part of the advancing care information performance category in the Merit-based Incentive Payment System:

The coalition also attributes limited progress toward widespread interoperability via the EHR Incentive Programs to ONC leadership and warns against a similar effect in realizing the goals of the 21st Century Cures Act.

Health IT Now letter emphasizes the need for the Health IT Advisory Committee, which was created by the latter, to avoid the pitfalls other previous committees.

“The law allows the Secretary to identify additional priority target areas. In the past, the Health IT Policy and Standards Committees have focused on many ONC-defined priority areas, yet lost sight of what should be their ultimate goal – achieving widespread interoperability,” claimed White.

“The yet-to-be-formed Health IT Advisory Committee will represent many diverse stakeholders, all of whom will have their own individual priorities,” he continued. “We urge HHS to not lose sight on the end goal again and to ensure that all target areas will help reach interoperability.”

ONC’s authority over health IT standards is also questioned.

“Focusing on standards used in the private sector is essential to reaching interoperability. Unfortunately, when Meaningful Use was first implemented, ONC decided to require standards that were not widely used in the private sector,” White stated. “This set back the pace of interoperability and led to needless burden on providers. To correct this mistake moving forward, we encourage HHS use what works in the private sector.”

All told, the coalition made six recommendations to HHS:

ONC was one of several HHS departments whose funding is slated to be reduced by the Trump Administration. In the POTUS 2018 budget proposal, ONC would receive a 36-percent reduction in funding — from $60 million down to $39 million — as part of major savings and reforms. According to the President’s proposed budget, the reductions would serve to refocus ONC on high-priority areas.

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