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Compliance, health IT adoption hot topics at ONC meeting

Don Fluckinger, News Director

Earlier this month, Sen. Al Franken (D-Minn.) rode political fences, first by calling for stricter health care data breach regulations and then by proposing

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faster medical device approvals. The response to the former from Office for Civil Rights (OCR) Director Leon Rodriguez, as well as successful next-generation health IT adoption strategies, ranked among the highlights of the recent Office of the National Coordinator for Health IT (ONC) annual grantee meeting in Washington, D.C.

Rodriguez represented the OCR before Franken and the Senate Judiciary Committee on Nov. 9. Franken told the OCR to "hurry up" with finalizing and enforcing currently proposed HITECH Act rules to extend HIPAA regulations -- and penalties -- to HIPAA business associates, including e-prescribing and personal health records vendors.

"We have taken Senator Franken to heart," Rodriguez said during the Nov. 17 ONC meeting.

Fortunately for Rodriguez, Franken was not all business. The new OCR director told the audience assembled at the ONC meeting that, prior to his Senate Judiciary Committee appearance, the largest legislative group before which he had testified was the Montgomery County (Md.) Council.

While that might have been a little intimidating, Franken set him at ease. "I think most of you remember Senator Franken from his days on Saturday Night Live, and I am here to assure you that Senator Franken had the same sense of humor as a senator as he did when he was on [SNL]," Rodriguez said.

In his ONC presentation, Rodriguez also outlined the nuts and bolts of HIPAA-mandated IT risk analysis. He stressed that HIPAA covered entities are supposed to not only conduct risk analyses and correct deficiencies they uncover -- senior leadership also must understand security compliance and what is being done to enforce it, and they must give compliance and IT staff the appropriate resources to carry out federal security mandates.

"This is a perfect time to be reviewing your HIPAA compliance programs," Rodriguez said -- that is, before the OCR issues the HIPAA enforcement final rule that may catch less-prepared health care providers by surprise. 

Past, present leaders measure progress of EHR adoption

Former national health IT coordinator and present Harvard health policy professor David Blumenthal, M.D., said that one of his goals when he first took the ONC job in 2009 was to create a sense of "inevitability" of nationwide electronic health record (EHR) implementation and health information exchange, despite what health care stakeholders could view as possible imperfections in the laws, regulations and incentive programs surrounding it.

"If we could change the views of our colleagues throughout the United States in terms of how health information technology was going to play a role for them in the future, that was another way to win," Blumenthal said.

Current data that shows increasing EHR Incentive Programs payouts and broader EHR adoption is encouraging, he said, as well as his own personal experience working for Harvard partners Massachusetts General Hospital and Partners Healthcare System.

"I do get a sense, being there, that on this score of creating a sense of inevitability, we have made huge progress. Meaningful use is now just a fact of life," Blumenthal said.

Health IT adoption must move at speed of technology, not medicine

Blumenthal's replacement, Farzad Mostashari, M.D., offered an informal "state of the union of health IT." Meaningful use has accelerated the advance of health data systems over the last two and a half years, he said. Pointing to indicators such as half of EHR software systems now including an iPad application, as well as the traction cloud-based health IT systems are getting in the marketplace, health care tech is experiencing an "explosion of innovation," Mostashari said.

The speed of change in technology, and the speed of change in medicine, are two different speeds.

Jay Walker, curator, TEDMED

Health care, however, is only partway to catching up with consumer-driven technologies like smartphones and other devices, said Jay Walker, curator of the future-looking TEDMED Conference. He exhorted the grantees assembled at the meeting to keep their eyes on the prize of creating better health IT networks and data tools that will improve patient care.

Only after a retrospective look at technologies can people see the most important innovation of the day, he posited, such as the Jacquard loom punch cards of the early 1800s that technologists consider a direct ancestor to today's computers. It will be up to the 1,200 technology developers and implementers in the audience, he said, to figure out which technologies can be applied best in health care and to let health IT adoption play catch-up with the outside world.

"The speed of change in technology, and the speed of change in medicine, are two different speeds," Walker said. "'Tech-speed' is the world we live in; 'med-speed' is the world you work in. You are the front-line change agents bringing tech-speed to med-speed."

Let us know what you think about the story; email Don Fluckinger, Features Writer.


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