COVID-19 response, modernizing public health data systems and keeping health equity top-of-mind proved key themes at HHS’ Office of the National Coordinator for Health Information Technology’s two-day annual meeting, which ended Tuesday.
Here are the five highlights from the meeting:
1. Data-sharing as the “default.” ONC chief Micky Tripathi during opening remarks Monday said the agency’s landmark information-blocking and interoperability rule, parts of which take hold next week, will force the healthcare industry to move data-sharing up the priority list. The rule’s information-blocking provisions, which bar healthcare providers and certain software developers from blocking access to data unless they meet certain exceptions, will instill an “attitudinal change about the way we think about sharing,” so that exchanging information becomes the “default.” It mirrors a sentiment Tripathi expressed at AcademyHealth’s Health Datapalooza & National Health Policy Conference in February, stating the information-blocking provisions would force a “culture change.”
2. APIs in public health. Officials from numerous federal agencies are working to see if the same standardized application programming interfaces—technology that allow different applications to share data with one another—required in ONC’s rule will streamline aspects of public health. ONC is working with the private sector to see if there are ways to leverage standard APIs so that patients can view vaccine appointments through the Centers for Disease Control and Prevention’s VaccineFinder website, Tripathi said. VaccineFinder currently displays what healthcare providers in a user’s region are distributing vaccines, but does not show specific appointment availability. Dan Pollack, surveillance branch chief in the CDC’s division of healthcare quality promotion, during a panel said such APIs could play a role in automating hospital reporting to the center’s National Healthcare Safety Network.
3. Vaccine credentials. Tripathi said ONC is working with other federal agencies and the White House’s COVID-19 Response Team to assess approaches people the U.S. could use to prove their vaccination status as businesses reopen. That could involve credentials displayed through mobile apps, according to a recent Washington Post article, though Tripathi didn’t specifically mention app-based approaches. Tripathi had referenced ONC’s involvement in such efforts during a webinar hosted by consulting firm Sirona Strategies earlier this month, where he said a multi-agency group was working on evaluating considerations like privacy, security, fraud and equity. At the time, Tripathi said he didn’t like referring to them as “vaccine passports,” since the credentials wouldn’t be issued by the federal government.
4. Linking clinical and public health data systems. ONC officials emphasized that modernizing public health IT systems will require a shift in mindset, in which the healthcare industry stops thinking about public health, clinical and other data systems as distinct and separate from one another, and instead thinks about creating a data-sharing ecosystem that includes all of the healthcare sectors. “The need for inter-connected public health and clinical data systems is very, very clear” in light of COVID-19, said Elisabeth Myers, deputy director in ONC’s policy office, during a panel. That’s one of the reasons ONC recently granted $2.5 million to health information exchanges working on public health projects.
5. Health equity. Tripathi said ONC is starting to think about “health equity by design” as a core principle, which he described as considering health equity concerns at the start of developing new policies and systems, rather than as something to assess down the line. A first step to improving health equity and reducing health disparities involves establish standards for how organizations collect and share data on social determinants of health, so that providers can get a more complete picture of a patient’s health and public health agencies can assess whether efforts like the vaccine rollout are reaching all populations. “We can’t fix what we cannot see,” said Dr. Marcella Nunez-Smith, chair of the U.S. COVID-19 Health Equity Task Force and associate dean for health equity research at Yale School of Medicine, during a session. “We have to begin with visibility in the data.”
In recent years, ONC has tackled that by starting to incorporate social factors into its interoperability standards advisory and requirements for health IT software developers seeking certification from the agency, officials said during the meeting. HHS agencies like the Administration for Community Living and CMS have also been pursuing new ways to encourage collecting and using social determinants data.