John Halamka: How Karen DeSalvo can 'polish' ONC's strategy

While Beth Israel Deaconess Medical Center CIO John Halamka believes that Karen DeSalvo is the "right person" to lead the Office of the National Coordinator for Health IT at this point in time, there are several elements of the agency's strategy he says should be changed.

In a new post to his Life as a Healthcare CIO blog, Halamka (pictured)--who also serves as vice chair of the Health IT Standards Committee that makes recommendations to ONC--first and foremost, says that the electronic heath record certification program is in need of a redesign.

"Some of the 2014 Certification test procedures have negatively impacted the healthcare IT industry by being overly prescriptive and by requiring functionality/workflows that are unlikely to be used in the real world," Halamka says, the result of which, he points out, is a delay in 2014 certified product availability. "Certification should focus on rigorous interoperability testing, using mature standards, in practical use cases, supported by the evidence and experience."

Halamka--a FierceHealthIT Editorial Advisory Board member--also talks about nixing non-compliance penalties for providers for Meaningful Use Stage 3, and says that specific EHR functionalities aside from interoperability and security should not be mandates. "Meaningful Use will have succeeded if we capture the gains of Stage 1 and 2, then focus on Stage 3 incentives that drive us to better outcomes, rather than penalizing providers for not checking more attestation boxes," he says.

Halamka also suggests making a number of alterations to federal mandate timelines, including:

  • Extending Meaningful Use Stage 2, Year One attestation by six to 12 months
  • Re-evaluating quality measure submission requirements for the Affordable Care Act
  • Rethinking the scope and timing of accounting of disclosures for HIPAA

"Thousands of pages of regulations are hitting the industry at the same time, and it's clear that like HealthCare.gov, haste will make waste," he says.

Halamka has been sounding the alarm about mandate timelines for quite some time. In November, he said that even "well resourced" health institutions will have difficulty navigating the busy regulatory landscape in the coming year.

Shortly after it was announced that DeSalvo would be taking over as National Coordinator, Halamka told FierceHealthIT that she appears to follow in the tradition of prior coordinators David Blumenthal and Farzad Mostashari in that she's "more policy focused than technology centric." He reiterates those thoughts in his new post.

"She is a cheerleader for IT, not an informatics expert," Halamka says. "She'll rely on others to help with the IT details, and that's appropriate."

To learn more:
- read Halamka's full post

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