HHS Secretary Alex Azar on Monday voiced frustration over stakeholders who are "fiercely" pushing back against the department's proposed interoperability rules.
"Health records today are stored in a segmented, balkanized system," Azar said during keynote remarks at the 2020 annual meeting of the department's Office of the National Coordinator for Health Information Technology in Washington, D.C. "Unfortunately, some are defending the balkanized, outdated status quo and fighting our proposals fiercely."
But defending the current system is "a pretty unpopular place to be," he added.
The two interoperability proposals, released by the ONC and the CMS early last year, are a core component of the Trump administration's larger vision of "putting patients at the center of American healthcare," Azar said.
The rules are designed to make it easier for providers, insurers and patients to exchange health data, in large part by requiring providers and insurers to adopt standardized application programming interfaces, or APIs—protocols that connect IT systems like electronic health records with third-party apps.
But the companion rules, which have yet to be finalized, have proved controversial.
Provider groups have repeatedly voiced concern that the regulation's focus on allowing patients to download their health data using third-party apps creates privacy concerns, since app developers aren't held to the same privacy standards as providers and insurers. And developers of EHR systems have argued that the ONC's move to limit fees that suppliers of data-sharing technology can charge disincentivizes innovation.
Azar said the department would continue to solicit input from healthcare stakeholders while determining how to implement the proposed rule. However, he maintained that the interoperability proposal laid out an "intuitive, appealing standard" for ensuring patients have access to their health records.
"Scare tactics are not going to stop the reforms we need," he said.
Azar didn't specify what "scare tactics" the department had seen in his remarks. But his comments come just days after a Politico report that Judy Faulkner, CEO and founder of Epic Systems Corp., said the EHR giant might sue HHS if the department finalized the interoperability proposals without addressing concerns over privacy protections.
Epic told Modern Healthcare that they want to work with HHS to "fix the proposed rule and make sure it's a good one."
"Epic's focus is on saving lives and improving healthcare for patients, and we have no interest in pursuing a lawsuit," the company said in a statement.
During his remarks, Azar shared how bolstering interoperability could support other components of the Trump administration's healthcare agenda, such as price transparency.
President Donald Trump in late 2019 signed an executive order requiring hospitals to publish their standard charges online starting in January 2021. Azar suggested that opens the door to develop tools that integrate price information with patients' clinical data, to provide patients with a fuller picture of the services they're receiving and what they're paying for them.
"Working toward these kinds of goals is a redefinition of the role of government in healthcare," Azar said. "Government not as a heavy-handed intervener, but as an enabler of private sector innovation and competition."
