The Biden Administration Direction on Interoperability
Episode 1522nd January 2021 • This Week Health: News • This Week Health
00:00:00 00:07:01


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 Today in Health it, the story is what the Biden administration means for interoperability. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping Health IT staff current and engaged. Today's sponsor is me. I provide executive coaching for health leaders around technology and it.

If you wanna learn more, check out health Alright. . Today's story, Mickey tpa was named by the Biden administration as the National Coordinator for Health It. I love this appointment. Uh, one of the most informative episodes on interoperability we've ever done was with Mickey last year on this week in health.

It, I. Uh, his knowledge and experience is, is really deep on the subject. Uh, he has proven to be, uh, apolitical on the subject and can easily work across the aisle and he will hit the ground running. Uh, we sat down with Mickey last year on this weekend, health It, and he gave us a great rundown on the, the past, the present, and the future of interoperability.

Uh, today I want to take out my crystal ball and see if we can't predict where the Biden administration might go with regard to interoperability and the answer. I'm gonna just cut to the answer. The answer is full speed ahead in the same direction I. There's very few things I think that from the last administration to this administration are gonna be in this, uh, fashion.

But, uh, interoperability efforts on a national level are being driven by two main forces. Uh, the 21st Century Cures Act and advancements in fire. And the standards for that matter. Right. So, uh, nothing's gonna change really for two reasons. First, uh, the 21st Century Cures Act was passed under the Obama administration, which President Biden was a part of, and it was the last piece of major legislation that I can remember that was bipartisan.

I was gonna say that was this bipartisan, but, um, but this was really amazing. It, they passed the house by a vote of, uh, 3 92 to 26 and the Senate by a vote of 94 to five. That's an awful lot of Democrats and Republicans agreeing on this legislation. Uh, so the first reason is that. We agree. Yay. The second reason is because the current president understands this topic better than most.

He has poured himself into interoperability as part of the Biden Cancer Initiative and has even met with leaders in the industry on this very topic. There is a now infamous exchange between President Biden and Epic, CEO, Judy Faulkner on interoperability that has been described as cordial and in the spirit of finding solutions, but it's still interesting to look at in this context.

The topic was access to patient records. And according to someone who was in the room, Faulkner said, why do you want your medical record? There are a thousand pages in length and you, you only understand about 10 of them. To which Biden replied, it's really none of your business. If I need it, I'll find someone who can explain them to me.

And by the way, I will understand a lot more than you think I do. Or don't like his politics. This president gets interoperability and is asking the right question. You know, whether it's a cordial kind of exchange or a, come on, Judy, you've gotta be kidding me. Kind of moment. Uh, it doesn't really matter.

He's asking the right questions. He understands the value of interoperability and is putting the patient first, which is, uh, what we're looking for. 21st Century Cures has three components to keep an eye on. Uh, TECA the Trusted Exchange framework with a, a governance mechanism, uh, which is the RCE, the recognized coordinating entity, which I think is the, I'm pretty sure is the Sequoia project, uh, which is pretty awesome.

So, uh, TECA. Is not required to participate in, but, and, and that's something itself to keep an eye on. It's, it's not like meaningful use where you're forced to be a part of it. Uh, TEF FCA is a voluntary kind of participation. Uh, the second thing is information blocking, uh, the default for sharing the medical record defaults to share.

With penalties for blocking. Uh, this is different than what we used to have. Uh, there are really seven exceptions, but the sharing entity has to make the case as to why not to share versus why to share. And then, uh, finally, the use of Russell APIs and more specifically, fire to share information. Uh, if I had to throw in one more thing, it would be the U-S-C-D-I, uh, which is the evolution of the core clinical data set.

Uh, this sets the standards for the data that will be shared between health entities. Uh, this is the law and it's not changing. Well, it could change, but it would require a political will to, to change it. And right now there's no movement to change it. So it's full speed ahead on interoperability under the Biden administration.

Now, will there be changes? Of course. Uh, you know, you from one. And well, from one administration to another, there's gonna be changes, but not with regard to interoperability. You know, we're likely to see a return to bundle payments and an emphasis, uh, you know, not on creating a functioning market like in the previous administration, uh, for healthcare, but, but rather, uh, a government program to, to grow the, the list of the insured, right?

A return to exchanges and likely some form of expansion of Medicaid and potentially Medicare. But, uh, you know, there's less known about a Medicare expansion at this point. Uh, and that's really a topic for another episode. Uh, the so what it's full speed ahead under the National Coordinator for Health It, Mickey Tripathy don't expect much of a change with regard to interoperability.

That's all for today. Don't forget to check out this week in health it Newsday, where I discussed the news with a pier from the industry drex to Ford. And I discussed this very topic on Monday's show, so you won't wanna miss that. If you know of someone that might benefit from our channel, please forward them a note.

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