New data-sharing regulations will soon go into effect that lay the groundwork for patients to have easier access to their health information.
When will patients start to see the benefits of these new mandates?
New federal health IT leader Micky Tripathi, Ph.D., believes it's already happening.
"A lot more is happening behind the scenes that benefit patients that they don’t appreciate. Think about information flowing through networks today: a lot of that does benefit patients," Tripathi, the new national coordinator for health IT, said Thursday during a virtual fireside chat as part of Health Datapalooza.
"My father passed away from cancer a few years ago, and we had his health information on five different portals. At that time, I didn’t complain that his information wasn’t on one portal. I was just grateful that I could get it and we had five portals. It's incremental improvements," said Tripathi, only three weeks into his new post as chief of the Office of the National Coordinator for Health IT (ONC).
Tripathi said the new regulations will open up an app ecosystem that enables patients to engage with healthcare on their smartphones and through health apps.
"We haven't broached or embraced that yet," he said.
He also acknowledged, however, "That doesn’t mean we’re anywhere near where we need to be."
In late January, Tripathi was tapped as the new national coordinator for health IT under President Joe Biden's administration. The ONC provides counsel for the development and implementation of a national health information technology framework.
The new data sharing regulations were shaped by Tripathi's predecessor, Don Rucker, M.D., but future progress on data interoperability is now in Tripathi's hands.
In March 2020, the Trump administration released widely anticipated rules that prohibit the blocking of information sharing and will change how providers, insurers and patients exchange health data. Specifically, the regulations will allow patients to access and download their health records with third-party apps.
The rules have faced some industry pushback, and compliance deadlines has been delayed because of the COVID-19 pandemic. Providers aren't required to come into compliance with the information blocking requirements until April 5.
As part of the rule, the ONC is calling on the industry to adopt standardized application programming interfaces, specifically Fast Healthcare Interoperability Resources, to help allow individuals securely and easily access structured electronic health information using smartphone applications.
An expert on interoperability, privacy and technology standards, Tripathi most recently served as chief strategy officer at Arcadia, a population health management solutions company.
Tripathi said he's confident that the 21st Century Cures Act, which was signed into law in 2016 and mandated the interoperability and information blocking rules, represents a "paradigm shift for the industry."
"It's a significant difference from everything we’ve had in the past, in that, it forces a culture change. The Meaningful Use rules and certification were about, here are a set of rules, and then it’s humans being humans, people start to interpret the rules to the letter," he said.
"Where the Cures Act comes in, we’re getting at the spirit," he said. "This isn’t about the letter, this is the spirit we want to accomplish and then we figure out how we want to proceed."
While there is intentional information blocking occurring in the industry, interoperability challenges also still exist because healthcare providers, payers and vendors haven't put the issue on top of the priority list, Tripathi said.
"In some cases, it's not about maliciously stopping things. It's that there are 10 other priorities that affect patient safety, and they have to focus on those. This is setting up a push to say 'Move this up on your priority list,'" he said.
While he's bullish that the new regulations will make it easier for patients to control their health data, he acknowledged that "interoperability is never done."
"In other walks of life, we think of it as being done, but it's not. We can withdraw money from any ATM and but we can’t deposit money into any ATM. We can't download a Kindle book and read it on a Nook device. We don't have full interoperability anywhere," he said. "We have a long way to go before we’re at the level we want to be."
ONC also will need to focus on ensuring health IT regulations don't have negative unintended consequences, such leaving some patient populations behind in the shift to digital health.
The Department of Health and Human Services' health IT arm needs to strike the right balance between certifying technology solutions to achieve safety, quality and reliability without setting the bar too high.
"You don't want to have such a high bar that the systems become too expensive for providers working in underserved communities that have limited resources. We want to be sensitive to that," he said.
At the same time, ONC needs to push forward certifications and regulations that make health data accessible and available to patients through different formats, including smartphones and web portals.
"We want to open up a competitive marketplace and also recognize that there is a spectrum that needs to be addressed and accounted for," he said.
ONC also is working to define the data elements of social determinants of health data, Tripathi said.
"We're working with other federal partners on the business requirements related to and we're looking to help to standardize some of that, make that available and have better ways of using that data," he said.