- Increases in EHR adoption and the growth of EHR use since the passing of the law creating the EHR Incentive Programs and defining the authorities of the Office of the National Coordinator require Congress to provide the federal agency with new powers related to health data blocking.
That's what National Coordinator Karen DeSalvo, MD, MPH, MSc, told members of the House Committee on Oversight and Government Reform during a Subcommittee on Information Technology hearing on Tuesday.
"You are touching on the challenge that has emerged since we have been adopting electronic health records and moving to a digitized system — that is, that state laws vary and there is some need to harmonize that," DeSalvo responded to a question from Representative Gerry Connolly (D-VA) about gaps in information sharing.
"In the short run, the Office of the National Coordinator has worked with the National Governors Association on developing a tool kit so that the states themselves can harmonize their privacy expectations so that won't be an unnatural impediment to information flow. Over the long term, clearly the health IT landscape has changed since HITECH was passed in 2009," she said of the federal agency's previous work on health information exchange.
When further prompted by Connolly about regulatory changes needed to address disparities in health information exchange, DeSalvo agreed with the possibility of Congressional intervention to reduce these obstacles to data sharing.
"We certainly are leveraging all the opportunities that we have at ONC and our partners at the Office for Civil Rights and other agencies to see that we're protecting consumers and that data is going to flow," she explained. "But there are areas where we know there may be some opportunity like information blocking where we would need some additional support."
Following recess, the hearing about opportunities and challenges for advancing health IT turned into a conversation about health data blocking and strategies for reducing its prevalence.
When asked to go into further detail about health data blocking by Representative Ted Lieu (D-CA), DeSalvo admitted that it is a consequence of more and more healthcare organizations and providers adoption forms of health IT.
"This is a new challenge we wouldn't have had years ago when we did not have a digitized system," she emphasized. "It has emerged since 2009 when the HITECH Act put ONC and our authorities into place. "It's an area where since 2009 the world has really evolved and that's why in our budget request we did put forth a proposal asking for some more opportunities for us to be able to address blocking, to see that where data could move that it would. We really welcome the chance to talk to you more about the ways that we think we could have more opportunity to address it."
According to the National Coordinator, ONC has worked with its current powers to promote information sharing and prevent data blocking in conjunction with the Office for Civil Rights and Office of Inspector General, but more needs to be done and without additional authorities the federal agency will not be empowered sufficiently to address these health information exchange challenges.
"Yes, we do believe that since the world has evolved there is a new need for us to have some additional opportunities to protect the people who are using systems and more importantly to protect the data of the consumers," she noted. "What we have asked for as part of our budget request is some additional opportunity around defining it, giving us the opportunity to require that vendors, for example, can't use gag clauses to prevent providers from talking about some of the contractual elements."
View the full hearing and witness testimony here.