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Promoting Interoperability and Change at the Annual ONC Meeting: Day 1
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The Office of National Coordinator (ONC) Annual Meeting brings together leading innovators, policymakers, developers, and advocates across the health IT sector to engage in the most pressing policy and regulatory topics facing the industry.  This year marked ONC’s 10th Annual Meeting, which was held in Washington, DC on Jan 27th and 28th, and featured keynotes by Alex Azar, Secretary of Health and Human Services, and Don Rucker, National Coordinator for Health Information Technology.  Both Secretary Azar and National Coordinator Rucker focused on federal regulatory priorities, in particular, ongoing interoperability and transparency efforts, as a way to help enable private-sector innovations that put patients at the center of healthcare.  Major themes throughout the meeting included the need for patients to have increased choice, better access, and safer care delivery through the use of health IT solutions.  Underpinning these priorities is heightened motivation to change the status quo so that seamless value-based care delivery can be realized to improve patient outcomes and reduce costs.  
Day 1 Recap
Secretary Azar, who delivered the Monday morning keynote address, challenged the current balkanized system and advocated for patient empowerment and strong protections for patient privacy.  He pointedly stated that “scare tactics won’t stop the reforms we need” highlighting the continued advocacy and support for the release and implementation of the pending ONC and Centers for Medicare and Medicaid Services (CMS) interoperability rules, which are still under review at the Office of Management and Budget. The rules focus on ways to eliminate information blocking and propose regulatory accelerants to promote transparency, such as giving patients increased access to their health information through the development of open APIs, public reporting mandates, and requiring hospitals to share data with other providers on their patients. Secretary Azar made the case for transportable medical records across-providers, empowerment of patients while protecting privacy, giving providers choice in solutions, increased price transparency, and better integration of clinical and financial data.  His advocacy on these policies was powerfully supported by his own frustrating experiences trying to obtain his medical records and rectifying non-consented prescription drugs. Throughout his talk, Secretary Azar reaffirmed his stance of the government’s role as the enabler of private sector innovation as a way to more rapidly achieve a seamless delivery system that operates under value-based care.
As part of the morning plenary session, Congressman Bill Foster (IL-11) provided a Congressional perspective on our collective imperative to improve information sharing as a way to address significant safety issues in healthcare.  He pointed to a 2016 Johns Hopkins study that found medical errors accounting for over 250,000 deaths annually, making it the third leading cause of death in the United States after heart disease and cancer. He highlighted how cross-provider information sharing, interoperable solutions, and unique patient IDs can significantly improve patient safety and quality of care. He also added how such solutions could have helped detect the opioid crisis sooner and allowed for a more rapid and coordinated response from the provider side.  
Adding to the first part of the morning plenary was a panel discussion on unique patient IDs (UPIs), during which panelists representing the patient advocacy, technology, public health, and provider communities highlighted their varying perspectives.  The panel discussed the opportunities and challenges associated with UPIs and provided important considerations for patient safety and privacy as information is exchanged and reconciled across a very diverse and fragmented healthcare care system. The panel highlighted the complexities involved with UPIs ranging from costs, uncertain buy-in from strategic interests, technology challenges including effective scaling of solutions, risks to ubiquitous implementation coupled with a long implementation timeline, as well as fraud and trust considerations.  
During the afternoon ONC Town Hall, the ONC leadership team gave insight into their roles and took audience questions on various topics, including the rule making process, upcoming ONC priorities, and patients’ ability to correct their medical records among others. ONC leaders also reaffirmed the agency’s role as promoting and enabling needed innovations and therefore continues to seek private sector engagement to ensure as many perspectives, concerns, and recommendations as possible can be incorporated into its work. In particular, ONC currently seeks comments on its recently released 2020 – 2025 ONC Strategic Plan which looks to achieve 4 main goals:
  1. Promote Health and Wellness

  2. Enhance the Delivery and Experience of Care

  3. Build a Secure, Data-Driven Culture to Accelerate Research and Innovation

  4. Connect Healthcare and Health Data through an Interoperable Health IT Infrastructure

As part of the afternoon plenary on Innovations in Health IT, PatientPing’s CEO, Jay Desai, along with other leading industry innovators discussed with Wall Street Journal reporter and moderator, Melanie Evans, the impact of the proposed ONC and CMS Interoperability rules on patients, providers, and the technology sector.  The panel agreed that information blocking is a continued problem and viewed the proposed rules as positive avenues to move the country forward on interoperability efforts.  The panel also agreed that while technology solutions are largely available already, there is a need for increased buy-in, more aligned incentives, and streamlined workflows to make more significant and faster progress towards the interoperability goals outlined by ONC and CMS in their respective rules. The panel also touched on the importance of patient privacy considerations in light of increased data access via APIs but saw it as an addressable concern that should not prevent forward progress on interoperability and value-based care.
The day also offered a total of 24 separate break-out sessions that covered a wide range of topics, including artificial intelligence in health IT, advancing interoperability standards, Social Determinants of Health (SDOH), electronic clinical decision support for opioid prescribing among many others.  The day was filled with numerous important perspectives and optimism about current opportunities to make significant progress in empowering patients, improving access to data, and creating a more seamless delivery system.
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Promoting Interoperability and Change at the Annual ONC Meeting: Day 1 - by Megan Flanagan - 01-30-2020, 03:18 AM

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