In his first briefing with the media since taking over as National Coordinator for Health IT in August, Vindell Washington talked at length about the role of his office going forward, with particular attention paid to oversight interoperability.
Discussing the potential expansion of ONC’s oversight abilities, Washington said such responsibilities clearly fall within ONC’s purview.
“There’s this idea that we need a little bit of an ability to do direct oversight of the actual certification,” he said. “We have less-than-optimal oversight into the testing that goes along with certification, and then, the last sort of prong is around this idea of surveillance or some transparency on the surveillance side. I would say that it’s fairly driven by a maturation of the program and a maturation of the environment.”
Washington added that if ONC’s role from a certification perspective is to ensure the products providers are using to care for patients meet a certain standard, then as that matures, the structure that supports it must mature as well.
“That’s the concept behind our rule,” he said. “We have these relationships with the certifying bodies and the testing bodies, but that was a design piece at that point in time it was the right structure for that level of maturity. Making that choice at that point in time certainly didn’t narrow the possible implementation strategies that could be used in the future. That was a delegation that was done, rightly so, I believe, for that particular time in the market.”
When asked if ONC could handle additional oversight responsibilities if they are granted by the final rule with regard to budget, Washington said he hoped the requests made in President Barack Obama’s proposed budget for ONC would be honored. ONC’s allocated budget has remained relatively flat since the agency’s inception.
Regarding interoperability, Washington said ONC will continue to focus on evolution in three areas: the use of standards, changes in how care is paid for and cultural changes around the sharing of information.
“We’re focused particularly on those because we think those are the ones that are most likely to move the information sharing that we all desire for in the healthcare ecosystem,” he said.
Talking about standards, in particular, Washington called a public-private approach to development the best option.
“You kind of draw the lines in the road, but you allow enough room for innovation across the sector so that you end up in the best possible place,” he said.
Until standards achieved wide use, Washington said, they would remain a “whiteboard exercise.”
“Even if you and I decide we’re going to use certain standards, what I’m particularly interested in and what we’re leaning in on is having relatively specific use cases,” he said.