ONC’s John Fleming wants patients to have a single unified health record

John Fleming
ONC administrator John Fleming wants patients to have more control of their health record.

A senior administrator with the Office of the National Coordinator for Health IT said he wants patients to have a unified health record that could pull data from various medical providers into a single record.

John Fleming, the ONC’s deputy assistant secretary for health technology reform, outlined his vision that would give patients more control of their medical information during the International Summit on the Future of Health Privacy hosted by Georgetown University Law.

“I believe every American should have a single unified health record system that’s in the cloud and is under the full control of the patient,” he said, noting that this was his own belief, not an official position of the Department of Health and Human Services.

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Fleming acknowledged there are challenges associated with that approach, but he said the benefits of having information from various doctors and specialists in one centralized location would be invaluable for both patients and providers.

“Of course that creates more challenges when it comes to security,” he said.

Access to a single unified record aligned with Fleming’s overarching view that health data belongs to the patient. He also advocated for patients to be able to obtain copies of their medical record for free, a suggestion that was raised by a health privacy attorney at Datapalooza in April.

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A single patient record would allow patients greater control over who accesses their record and what information they can see. He imagined a scenario where a patient gives a provider a code that opens up access to their record, but excludes sensitive information like a mental health diagnosis.

“I think you’re going to see more and more that patients will control their information,” Fleming said.

In his first widely-available public appearance as an ONC administrator, Fleming also touched on a range of health IT and regulatory issues including his assertion that HIPAA needs to evolve to keep up with the demands of healthcare privacy and EHRs, and the wide range of state privacy laws that need to be boiled down into a manageable consensus.

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He also echoed the Department of Health and Human Services Secretary Tom Price’s vision for health IT, emphasizing ONC’s focus on EHR usability and interoperability. He admitted that although he doesn’t bring a lot of technical expertise, as a physician he considers himself an expert on the consumption of health technology.

To that end, he emphasized the importance of reducing the amount of time physicians spend in front of the computer, which he sees as a pathway to improve the quality of patient care.

“I can’t tell you how many times people have told me they are sick and tired of staring at the back of the neck of their doctor,” he said.

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