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February 19, 2017 11:00 PM

ONC lacks money, leadership to implement 21st Cures' tech provisions

Rachel Z. Arndt
Joseph Conn
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    Office of the National Coordinator for Health Information
    Jon White

    ORLANDO — One of the top priorities of the Office of the National Coordinator for Health Information Technology is implementing the data-blocking and interoperability measures listed in the 21st Century Cures Act.

    But, “We're in a unique time of transition,” said acting ONC coordinator Dr. Jon White at a town hall meeting at this year's HIMSS conference.

    The 21st Century Cures Act, which was passed in December, will gain momentum as soon as the ONC gets a new leader under the Trump administration, White said.

    The broad law looks to expedite the federal approval of some drugs and changes how medical research is funded. It also deals with health IT and instructs the ONC to issue rules on interoperability and electronic health records, among other IT concerns.

    White said the new administration's priorities are in line with what the ONC has been working on: reducing the burden on providers and increasing interoperability.

    But some of the essential rulemaking required by HHS to implement the law may be in limbo, waiting on not just the naming of a new ONC chief, but also on needed federal appropriations.

    During a question and answer period, White was asked whether the lack of a presidentially appointed ONC leader would prevent the agency from writing rules to implement the law's HIT provisions. Dr. Tom Price was only confirmed as HHS secretary last week and ONC has no timeline for appointment of new leadership.

    Some rulemaking can proceed with the current interim leadership, White said, if the rules pertain to existing programs.

    But since the entire federal government is operating under a continuing resolution, spending is limited “to things that are continuing,” White said.

    For some new programs, “We'd need a new appropriation or language in a new continuing resolution” specifically authorizing spending on 21st Century Cures-related rules, he said.

    For example, Cures requires HHS though rulemaking to impose as part of the federal health IT testing and certification criteria, that developers not engage in information blocking.

    Fleshing out that mandate could require additional resources and might be subject to restriction until an appropriation is passed.

    And plenty of industry uncertainty remains. Though the call for interoperability was sounded loudly, with many EHR vendors citing the importance of the effort, some vendors were unsure about the potential rules to come out of the act.

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