HHS leaders in recent weeks have had harsh words for critics of two landmark—and controversial—proposals to regulate health data.
That charged language signals the Trump administration’s commitment to finalized rules on interoperability and data blocking coming down the pike, said Dr. David Brailer, chairman of the healthcare education firm Health Evolution and former head of HHS’ Office of the National Coordinator for Health Information Technology.
The ONC and the CMS released their companion proposals last February but have yet to publish final versions.
“Having been in the middle of that machine, when people aren’t sure what they’re going to do, the comments are very guarded,” said Brailer, who served as the nation’s first ONC chief after being appointed by President George W. Bush in 2004. “But when they’re committed to doing something they make it pretty clear, across administrations.”
HHS leaders haven’t just been voicing their commitment to interoperability. They’ve been taking the proposals’ critics to task.
“I want to be quite clear: Patients need and deserve control over their records,” HHS Secretary Alex Azar said at the ONC’s annual meeting in January. “Unfortunately, some are defending the balkanized, outdated status quo and fighting our proposals fiercely.”
He added: “Scare tactics are not going to stop the reforms we need.”
Two days later on Jan. 29, CMS Administrator Seema Verma said at the Center for Consumer Information and Insurance Oversight’s Industry Day that “disingenuous efforts by certain private actors to use privacy—vital as it is—as a pretext for holding patient data hostage is an embarrassment to the industry.”
Earlier this month, ONC chief Dr. Donald Rucker suggested that if hospitals were really concerned about patient privacy, they wouldn’t take patients to court to collect outstanding medical debts. “Your medical care is public because it’s now part of a court record,” Rucker said at AcademyHealth’s 2020 Health Datapalooza conference.
The harsh language is not totally unexpected. “This administration, compared to previous administrations, I think it’s safe to say is more combative than perhaps we’re used to,” said Jeff Smith, vice president of public policy at the American Medical Informatics Association.
That’s one component, but he also noted that while the tone may seem aggressive for health IT policy, it would be the norm for such controversial topics as drug pricing or insurance.
“Those quadrants of health policy are probably used to a little bit more assertive language coming from the administration,” Smith said. “We’re not used to (it) in the health IT space.”
Verma is no stranger to forceful commentary, particularly in her pushback to Medicare for All-style proposals. That’s been consistent in her stance on interoperability, too.
“For those of you that still subscribe to the outdated idea that you can deny patients’ access to their health records, I encourage you, in the strongest way, to change course and accept that those practices will come to an end,” she said when launching the CMS’ MyHealthEData interoperability effort in 2018.
In a statement to Modern Healthcare, a CMS spokesperson said, “Our challenge to the industry started long before the announcement of rulemaking and continues today. Starting in early 2018, Administrator Verma put the industry on notice and announced our promise to put patients at the center of their healthcare.”
A major concern shared by the American Hospital Association and the American Medical Association relates to patient privacy. Under the proposed rules, patients would be able to download their health data from providers and insurers using a smartphone app of their choice, even though app developers aren’t held to privacy standards like HIPAA.
Epic Systems Corp. launched perhaps the strongest campaign against the changes, with CEO Judy Faulkner urging the company’s customers to sign a letter to HHS opposing the rules. About 60 health systems signed the letter, CNBC reported.