Health IT momentum must be maintained through 'pivot,' DeSalvo says

Newly appointed National Coordinator for Health IT Karen DeSalvo talked about the importance of constant progression for health IT as ONC enters what she called a "pivot" stage, at a town hall meeting Thursday afternoon at the agency's annual meeting in Washington, D.C.

Eleven ONC officials in all participated in the meeting, in which audience members asked various questions focusing on policy, privacy, innovation and interoperability, among other topics.

"As we move from adoption to use, we need to continue momentum," DeSalvo (right) said. For example, she said, with regard to the applicability of payment reform "that is really a central place where it matters that there are standards around how data is entered, exchanged, shared and reported."

Piggybacking on those comments, Deputy National Coordinator for Programs and Policy Judy Murphy said that ONC is about more than just Meaningful Use.

"I like to use the Buzz Lightyear term, 'Meaningful Use and beyond,'" Murphy (left) said. "There's a need, not just to address other venues of care, but to make sure that we are creating that patient-centered record, and that everywhere the patient goes, the record, in fact, follows, whether [it contains] health data or longitudinal care planning.

D.C.-based consultant Bill Braithwaite, a former employee of the U.S. Department of Health & Human Services who helped to develop health information standards nearly two decades ago, asked the panel about ONC's plans to better prepare providers and vendors for privacy and security. Braithwaite prefaced his question by pointing out that in his experience, lawyers are constantly concerned about their clients getting "dinged," for their actions.

"There doesn't seem to be a mechanism for a company to write a situation down and get assurance from the government that when you come and audit them, they're not going to get dinged for what they're doing," Braithwaite said. "[The Centers for Medicare & Medicaid Services] does this in certain situation. Is there a possibility for your group or groups to do this and make folks feel more comfortable?"

To that end, Kathryn Marchesini, with the Office of the Chief Privacy Officer at ONC, said that ONC and the Office for Civil Rights are working together to develop a risk assessment tool due out later this year, geared toward helping small providers navigate the privacy and security requirements suggested for Meaningful Use.

"We are sensitive to the community that has those concerns," Marchesini said.

Meanwhile, with regard to interoperability, Doug Fridsma (right), ONC Chief Science Officer and Director of the Office of Science and Technology, and Kelly Cronin, a health reform coordinator, talked about integration, as well as "pain points" for ACOs.

"There's no one single vendor who can completely, vertically integrate all the information that needs to happen," Fridsma said. "As soon as you start having to engage in social services and things that are outside the traditional care-delivery system, you're going to have to get ... horizontal integration across vendors."

Added Cronin: "We're clear that ACOs can't fix the interoperability challenge; that's been made abundantly clear. But I don't think certification's necessarily the only answer."

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