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Under pressure, ONC still making noise

With its leadership and programs in flux because of uncertainty accompanying the new administration, ONC has produced a flurry of activity lately punctuated by a slate of sessions scheduled for HIMSS 2017 in Orlando coming up Feb. 19.

But even as remaining ONC officials (the top ones have departed) prepare for an active HIMSS presence, the administration of President Donald Trump has already made preliminary moves that appear to strike at some of ONC’s key initiatives and programs.

In any case, ONC is planning no less than eight sessions at the Orange County Convention Center:

  • A Town Hall event with the ONC leadership team (more about this later) about ONC’s role in the national health IT agenda
  • A demonstration of the SMART App gallery, a market developed under a cooperative agreement between ONC and SMART Health IT, an open standards based technology platform developer, about the gallery’s collection of apps that use FHIR (Fast Health Interoperability Resources), the HL7 International standard, and APIs
  • An update from ONC leaders about policy activities now underway at ONC, including 2015 Edition Health IT Certification program and alternative payment models, and upcoming health IT initiatives
  • An education session with the agency’s Office of Standards and Technology about health IT testing operations, pilot programs and standards coordination
  • A live demonstration by FHIR app developers of systems to allow patients and healthcare providers to share medication lists
  • A “fireside chat” on value-based care with Jon White, M.S., the acting national coordinator for health IT, and Kate Goodrich, M.D., director of the CMS Center for Clinical Standards and Quality and CMS chief medical officer
  • “Rock Stars of Blockchain in Healthcare,” a discussion with White and Steve Posnack, director of the Office of Standards and Technology, about the fast-growing blockchain encryption technology’s potential for creating a secure and interoperable nationwide health IT system
  • An information session about ONC’s efforts to help providers and patients in using health IT for high-quality care


That’s a lot of health IT content from an agency that is little known to the general public, but wields plenty of clout in the industry and seems already to have drawn some perhaps unwelcome attention from the Trump administration in its first full week.

ONC’s parent agency, the giant Department of Health and Human Services, has asked that several ONC notices issued in recent weeks be withdrawn for more review, Politico’s Morning eHealth reported Jan. 25.

I should also note that Trump’s executive order freezing all new regulations extended to plenty of other agencies within HHS, and, indeed, to all federal departments and agencies.

As for the ONC provisions, they include one ONC was preparing to publish imminently that would trigger measures of the 21st Century Cures Act related to ONC’s EHR certification program’s updated usability and interoperability measures, and a rule that would set off a new process for refining quality metrics used in healthcare reimbursement.

HHS also withdrew a provision relating to how ONC selects the third-party certification bodies it uses to review EHRs and other health IT systems for eligibility in federal reimbursement programs, Politico reported.

The current certification bodies’ contracts expire in June and need to be renewed for three years.

The whole thrust of ONC’s health IT certification program is regulatory, and Trump, who as a candidate often criticized over government regulation, may be targeting just that if he views ONC’s regulatory efforts as unneeded or heavy handed.

On the other hand, this could also just be a blip for ONC.

As for the ONC leadership, the agency’s masthead is filled with plenty of officials with “acting” before their titles, reflecting a management corps that has been trimmed by departures.

The top leadership positions at ONC are filled with political appointees.

So former national coordinator Vindell Washington, M.D., Lucia Savage, former chief privacy officer, and Megan Roh, former communications and public relations director, all were political appointees and all left in concert with the end of the Obama administration.

Those positions have not yet been filled by the new administration.

Savage’s job is being done temporarily by Deven McGraw, who is on loan from the HHS Office for Civil Rights.

Andrew Gettinger, M.D., is still acting principal deputy national coordinator for health information technology, a title he has held for a couple of years.

Teresa Zayas Caban is chief scientist and acting chief of staff.

Thomas Mason, M.D., is acting director of the Office of Clinical Quality and Safety and chief medical officer.

Zhan Caplan is acting director of the Office of Public Affairs and Communication.

For a rundown of other top ONC officials, check here.