The Trump administration's top health IT official on Thursday said the healthcare industry would be better poised to address the coronavirus pandemic had HHS' recently released interoperability regulations been around earlier, even as the agency delays enforcement.
"If we'd had this rule several years ago, we'd be in a far, far better spot for … knowing what's going on with this pandemic," Dr. Donald Rucker, chief of HHS' Office of the National Coordinator for Health Information Technology, said during a webinar hosted by the Healthcare Information and Management Systems Society.
The fireside chat between Rucker and HIMSS CEO Hal Wolf was part of HIMSS20 Digital, a virtual conference launched after HIMSS had to cancel its annual trade show.
Rucker said improvements to healthcare interoperability would not only make it easier to gather data related to COVID-19 and how it spreads, but also could have allowed patients to corral their medical data across different sites of care—such as if they're using telemedicine for the first time, or transferred to another facility on account of a patient surge.
That's why some healthcare stakeholders had advocated against delaying the rule's implementation, in spite of the challenges created by COVID-19. But HHS last week unveiled plans to delay enforcement for some components of the ONC's rule, as well as for a companion interoperability rule issued by the CMS.
"We're in a pandemic now," Rucker said. "Because of COVID, we had to put a delay of enforcement in."
Together, the rules from the ONC and the CMS 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, better known as APIs.
APIs are protocols that connect various types of software, such as electronic health record systems and smartphone apps, to one another.
Rucker reaffirmed his belief that requiring standard APIs in healthcare will spur creation of new apps that provide patients with valuable services, such as price transparency.
"I believe an entire ecosystem will build out of that," he said. "I think the rules are a starting point."
A major concern over the rules voiced by provider groups has related to patient privacy. Under the rules, patients would be able to download their health data from providers and insurers using an app of their choice, even though app developers aren't held to privacy standards like HIPAA.
Rucker said, in "this modern, connected world," consumers are reevaluating how they think about privacy.
"Don't forget that every time you move one iota with your cell phone, day and night, people know where you are," he said, noting consumers regularly trade that for convenience brought by ride-sharing, banking and even weather apps. "I want to have instant weather at my location," he said.
Rucker added that technology can be used to safeguard patient data—by enforcing privacy and establishing consent—in addition to sharing information. The ONC has stressed that under its rule patients will be able to authorize which types of data they want to receive through a selected app.
"The privacy issues in healthcare are still absolutely paramount," Rucker said. But "as a world, we're rethinking exactly what privacy is."
