HHS steps back on NwHIN governance

HHS, through its Office of the National Coordinator for Health Information Technology, has decided to punt on its previous drive to regulate the proposed nationwide health information network.

In May, the ONC published a formal request for information—chiefly a list of more than 60 questions—that gave a sense of government regulators' thoughts on how the national network might be regulated.

Under the American Recovery and Reinvestment Act of 2009, Congress charged the ONC with establishing a "governance mechanism for the nationwide health information network."

But even that initial request for information received pushback from multiple organizations in more than 140 formal comments the ONC received.

"It was interesting," said ONC chief Dr. Farzad Mostashari, in announcing the policy shift at a meeting Thursday of the federally chartered Health IT Policy Committee.

"What we heard was, 'Listen guys, there is a lot happening, there is a lot of good information exchange that's occurring today—perhaps more than is widely appreciated,'" Mostashari said.

"And what we heard was that these activities are quite diverse in their architecture and in their business models, and one concern that we heard across almost every response was that regulation at this time may actually slow the development of trusted exchange, if it is implemented prematurely," he said.

"Our goal is to increase information exchange, not to hobble it or hinder it in any way, and it was something that we have to listen to carefully." Mostashari said. "So, the concern was, really, that as we're accelerating the implementation and expectations for standards-based exchange in Stage 2 that we could ill afford a pause while a regulatory process takes its course. And, as a result, we've decided that now is not the time, probably, to pursue a regulatory approach that follows what we laid out in the RFI."

Mostashari said the ONC will continue to provide guidance on best practices and to monitor what's going on.

Mostashari told policy committee members, however, that the decision to pause doesn't mean ONC will never move to regulate the NwHIN.

“If there are systemic issues, problems, market breakdowns that are actual, proven, systemic problems, let me assure you our proclivity, our tendency, our instincts are towards action,” he said. “If it ever turns out that if it makes sense to go back to a regulatory approach, whether it was outlined in the RFI or a modification of it, you're going to be the first to hear, because we're going to come back to the policy committee; we're going to review what we've learned, what are we seeing; and we're going to take it up again."