ONC’s Rucker says proposed regs will give patients power over their healthcare
ORLANDO, Fla.— Dr. Donald
Rucker, the national coordinator for health information technology, spoke with Modern Healthcare Editor Aurora Aguilar at HIMSS19 about two proposed rules aimed at preventing data blocking and improving interoperability. The following is an edited transcript.
MH: Is the stick the way to go to get interoperability moving?
Rucker: From my view, the providers already face penalties on information-blocking because in order to get paid by the CMS, they must prove they’re not blocking information.
MH: You’re talking about data that would inform outcomes or value, correct?
Rucker: Yes. Our whole mechanism of thinking about value in American healthcare now involves these very narrowly curated value networks or value metrics. For example, give me eight value measures. With the solutions ONC is proposing, electronic health records will have way more data than just those narrow quality measures.
MH: Will meeting these rules cost providers more?
Rucker: The 21st Century Cures Act set a few provisions on charges. Patients get their data as part of the care they’ve paid for. For example, let’s say you use Apple Health or some other app that says, “I’m going to collect all of your providers’ data for you.” That app cannot be charged by the provider to get the data.
The EHR developers are only allowed to charge costs reasonably incurred and that includes the cost of capital and the fully loaded cost of engineering.
MH: Is this going to solve the problem of interoperability?
Rucker: Over time, I think this will— combined with the modern app economy, the bandwidth that’s available— materially change the way care is delivered and the way patients are empowered. And we’ve designed this to allow new business models and new forms of competition.
Look at your smartphone and there’s page after page of apps. But there’s no Uber or Lyft in healthcare. There’s nothing really like a robust banking app or an aggregator site for healthcare.
And there just hasn’t been really entrepreneurial activity in this space because people haven’t had any access to the data. And what data has been accessed is very guarded, very proprietary. I think patients have not been empowered in the American healthcare system frankly, since the start of Medicare. This is a way to get patients back into the game.