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DirectTrust Seeks POTUS Support of EHR Interoperability, HIE

DirectTrust has called on President-elect Donald Trump and his administration to foster continued advancements in EHR interoperability and health data exchange.

By Kate Monica

- Earlier today, the organization released a four-point list of recommendations for the incoming administration outlining ways to build on the foundational work done by its predecessors in the areas of EHR adoption and interoperability.

DirectTrust on EHR interoperability

On Tuesday, the President-elect’s Transition Team reviewed the recommendations at a closed-door meeting.

DirectTrust, a healthcare industry alliance comprising members of the Direct exchange network, facilitates interoperable personal health information (PHI) to improve care coordination among providers.

The organization recently announced its directory service has hit “critical mass” with 500,000 entries ranging from Direct addresses to specialty information and provider identifiers. DirectTrust CEO and President David C. Kibbe, MD, MBA, credited EHR Incentive Programs and meaningful use requirements with bolstering Direct exchange.

The focus now is on sustaining that progress and finding ways to grow further. “Our hope is that the momentum established to this point will continue under the new administration,” said Kibbe in today’s announcement.

To ensure DirectTrust and other similar initiatives aimed at health IT adoption and healthcare interoperability, its leadership submitted four recommendations for the Executive Branch.

First, the organization sought strong, competent leadership with extensive knowledge of key health IT standards for interoperability, security controls, and care coordination:

The President should appoint a strong leader at ONC. This person should be someone respected by the medical community and thoroughly versed in current and emerging healthcare technologies. We need a National Coordinator with the skills to speak to technical audiences on the key standards for interoperability, security controls, and content delivery that support value-based payments. Also important for new ONC leadership experience will be usability of the end-user’s IT systems, integration of IT into workflows for care coordination and making improvements to health IT certification, including real-world testing. 

Second, DirectTrust stressed the importance of maintaining the progress of previous EHR adoption and health data exchange efforts:

The new administration should seek to “hold the gains” in both EHR adoption and interoperability. New policies should build on existing technology for interoperable exchange already integrated into EHRs under the 2014 Certification Program, such as Direct Messaging, eHealthExchange, IHE-XDR and the CCDA, while supporting development of new technologies and evolving content standards, like FHIR. The new administration should avoid “throwing the baby out with the bathwater.”

Third, the alliance highlighted the importance of secure transport mechanisms to the new administration in order to ensure health data security as part of more robust information sharing. He believes DirectTrust needs policy and operational efforts centered on specific core requirements:

Given the current concerns about security and health care, it is critical that we use the latest secure, reliable transport mechanisms to move data, and that policy and operational efforts focus on core requirements, such as encryption, authentication and identity management.

DirectTrust concluded its list of advisements with a focus on holding providers accountable for improved outcomes.

Regulatory requirements that hold providers accountable for improved outcomes, such as those included in MIPS and MACRA, should be clear, targeted and evidence-based. This must be considered in the effort to reduce regulatory and documentation burden on health care providers, as specified in the newly-adopted 21st Century Cures Act section on Health IT.

The focus on “appointing a strong leader at ONC” is a priority DirectTrust recently voiced in the wake of President Barack Obama signing the 21st Century Cures Act into law on December 13. In a statement issued earlier this month, Kibbe emphasized a “vigorous approach to getting the work done” would result in forward movement and make room for innovations such as telehealth. On the other hand, appointing an unfit leader could result in stagnation, he warned.

The series of DirectTrust recommendations follows an encouraging third quarter for the health data exchange organization, with its Direct exchange users and HIEs increasing by nearly 66 percent. As of November, the number of DirectTrust users sharing protected health information had jumped 133 percent.

This increase in users and health data exchange reflects an industry-wide interest in transitioning toward care coordination and true interoperability.

“We look forward to working with the new administration and in particular, with ONC and CMS, to support interoperability and provide the industry with reliable means for secure and easy exchange of health information,” said Kibbe.

Dig Deeper:
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Breakdown of Health IT Interoperability Standards, Organizations