Navigating a New Normal in Times of Unprecedented Change: Reflections on My Conversation with ONC National Coordinator Donald Rucker, MD

By Hal Wolf, President & CEO, HIMSS

What strikes me most in times of great disruption are the new opportunities that lie in wait.

We are certainly living in uncertain times, in an unfolding new normal that is shining a spotlight on the imperative need for technology to help connect us – to bridge the divide created at this unique moment in time by COVID-19 – and for critical information to provide a gateway for innovation in care to help support all the change that will follow this interesting time in the history of global health.

I have always been proud of the role HIMSS has placed in helping to navigate through times of disruption by providing opportunities for engagement and connection globally. Drawing upon our 80,000 members to help educate, empower and serve as thought leaders in lifting up the need for clear and connected use of information and technology to help transform health and wellness has never been more important.

As our ultimate goal is creating a world where everyone, everywhere, has access to a health and wellness ecosystem that works, we must continue to develop a path to get us there.

Over the past couple of weeks, there have been many new regulations announced out of the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS). The government intends for the combined regulations to provide patients with timely access to their health data to make informed healthcare decisions and better manage their care. The Department of Health and Human Services (HHS) also expects the regulations to place patients at the center of care delivery and provide them with more control.

The ONC Interoperability and Information Blocking Final Regulation implements key provisions of the 21st Century Cures Act focused on advancing interoperability; supporting the access, exchange and use of electronic health information (EHI); and addressing occurrences of information blocking.

On April 21, 2020, the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services, in conjunction with the HHS Office of Inspector General (OIG) announced a policy of enforcement discretion to allow compliance flexibilities regarding the implementation of the interoperability final rules announced on March 9, in response to the coronavirus disease public health emergency. The recent action provides hospitals and health systems an additional six months to implement the new requirements.

The pandemic in and of itself has presented sweeping change in our day-to-day lifestyle, in the way we live, work and play. Throw into the mix new rules and regulations to support advanced interoperability in order to better care for our population during this time, and you’re left in need of a way to help provide clarity to all the new information being presented.

On Thursday, April 30, I was fortunate to sit down with Dr. Don Rucker, the National Coordinator for Health Information Technology, from the Office of the National Coordinator for Health IT. During our hour-long conversation, The Washington Perspective: A Fireside Chat with the ONC National Coordinator, we unraveled the true intent of these new regulations and talked through other important activities supporting the critical need for interoperability to address the current pandemic and support the future of health.

The clear and non-negotiable need for interoperability played out throughout our conversation. Significantly, if we had the rules and regulations that we have today in place just two years ago, we would find ourselves in a much better situation in helping to navigate health needs during this pandemic. We would have access to critical clinical information streams and established access to telehealth to keep those in need of non-urgent medical treatment well cared for and out of the overwhelmed hospital setting.

In helping to address the need to rapidly advance global health efficiency through interoperability at the point of care, I was pleased to share some of the goals of the recently announced Global Consortium for eHealth Interoperability, a partnership between HIMSS, HL7 International and IHE International during our conversation. As we look ahead and seek ways to best implement the goals of ONC’s new regulations, the Consortium has the opportunity to play a critical role in sharing lessons learned, best practices, adoption metrics and expert guidance to rapidly drive adoption of standards-based health IT interoperability. These efforts will significantly support policy-based interoperability roadmaps and vision into reality.

Key issues around the need to ensure protection of patient data in order to help address privacy concerns, the ability to navigate clear price versus description of services offered to help patients in their healthcare decision-making process and the necessity to balance the speed at which we need solutions with the need for evidence-based decision making were also critical components of my discussion with Dr. Rucker.

The conversation left me with a renewed focus on what Dr. Rucker deemed as “HIMSS role of leading by example,” in helping to make the seemingly complex more understandable; in getting away from big buzz words like AI that can add unnecessary complexity for many to truly understand the purpose and application of new technology and sources of information. HIMSS plays a unique role in acting as a bridge to bring our 80,000 members together to share their best practices and innovations, providing encouragement that change can and has been done successfully. We are focused on bringing clarity to clinicians about the range of capabilities available and supporting them in helping to put application into practice in order to reach the ultimate goal of keeping the patient healthy and well.

I started in the fall of 2019 calling this year to be one of unprecedented disruption, at the time having no indication of where we would be today. This massive disruption leaves much opportunity in its wake. During this time of constant change, HIMSS is working hard to partner with the changemakers to reimagine health and reform the global health ecosystem through the power of information and technology.