As the Obama administration winds down, the new head of the federal government's health information technology program will continue to primarily focus on interoperability of electronic health record systems.
“There are places that are making a good progress,” said Dr. Vindell Washington in his first news conference as head of the Office of the National Coordinator for Health Information Technology at HHS. “But we're looking for a world in which there is easy flow” across the entire spectrum of healthcare.
Health information exchanges, organizations aiming to help healthcare providers overcome technical and social obstacles to interoperability, have made progress after a rocky start.
Washington said that as recently as January in his own emergency room medical practice he was able to electronically access patient information from certain healthcare providers, but with another, “a hospital just down the street,” he still had to rely on a fax to get the records he needed.
“Our general approach is to make the information available when and where the patients need it,” Washington said. “There's an opportunity to do more and do it more broadly.”
Washington became the sixth head of the ONC on Aug. 12, replacing Dr. Karen DeSalvo, who gave up one of her two hats to focus during the remaining months of Obama's second term on her duties as acting assistant secretary for health.
Washington said the ONC will continue its pivot away from EHR adoption to interoperability, noting that 98% of hospitals and three-fourths of office-based physicians have EHR systems, “a place that's quite frankly astounding” given the low levels of their use before the federal government stepped in and paid providers ($35.1 billion so far) to buy and “meaningfully use” them.
Washington said the ONC's work in information-sharing is “foundational” to three key administration programs to improve healthcare—payment reform, the cancer “moon shot” led by Vice President Joe Biden and the Precision Medicine Initiative overseen by the National Institutes of Health.
The ONC is “leaning in” to explore the potential of Fast Healthcare Interoperability Resources, an interoperability protocol overseen by Health Level Seven, a healthcare standards development organization. FHIR (pronounced "fire") relies on application programming interfaces, or APIs, to pull data from existing EHR systems.
Washington specifically called out an ONC-supported mobile app development project—Substitutable Medical Apps, Reusable Technology, or SMART, at Boston Children's Hospital—that's using FHIR to create tools for the Precision Medicine Initiative.
“Folks continue to believe there's great promise in the FHIR API,” Washington said. “We're pleased that that innovation is going on, and we're watching their progress.”