New Oversight Framework Addresses Digital Health Technologies

CAST | March 13, 2018 | by Donna Childress

Report focuses on electronic health records; supports interoperability, usability, safety, security, patient access, and flexibility.

Health IT Now (HITN) and the Bipartisan Policy Center have released a new oversight framework for health IT and digital health. Its focus includes electronic health record (EHR) usability, interoperability, safety, security, patient access, and flexible technology to support an evolving health care system. EHR Intelligence reported on the framework’s release in “New Oversight Framework to Promote EHR Usability, Innovation.”
The framework addresses concerns spurred by the Health Information Technology Economic and Clinical Health (HITECH) Act. While the act has increased the use of EHRs, one-size-fits-all EHR regulations and payment-related requirements have led to lower productivity, higher costs, and physician burnout.
The Bipartisan Policy Center and HITN formed a work group of more than 50 industry experts and stakeholders to guide Congress and the administration in making regulatory changes. It released “The Future Role of Government in Health Information Technology and Digital Health” in February 2018.


The recommendations say the government should focus on core consumer protections related to EHR systems and other digital health technologies and leave the rest to the private sector. The work group also felt the government should continue to play a role in non-regulatory functions, such as funding research to identify successful practices and adopting consensus standards within its own health IT to signal government support.
The oversight framework should promote technology that strives to improve population health, increase patient satisfaction, reduce per-capita health care spending, and enhance clinician and staff satisfaction.
It also should address these six technology outcomes:

  • Interoperability: Technology should facilitate interoperability and information sharing, to advance higher-quality, more cost-effective, patient-centered care.
  • Usability: Technology should reflect evidence-based, user-centered design principles; human factors science; and best practices and should be culturally competent.
  • Safety: Technology should support the delivery of safer care and help reduce patient harm.
  • Security: Technology should assure that only authorized individuals and processes can access information and that information is not altered or destroyed in an unauthorized manner.
  • Patient Access to Information: Technology should enable patients’ access to their own health information.
  • Support for an Evolving Health Care System: Technology should meet the changing needs of users and the health care system. 

To make further progress in interoperability, the government should rely on private-sector leadership and standards, robust testing, attention to provider-provider and provider-patient interoperability, coordination across federal programs, measurement of interoperability levels and progress, strong business cases to drive further interoperability progress, and effective federal enforcement of laws and regulations regarding patients’ right of access to their data and prevention of information blocking.
A future government role in interoperability should include designing payment and delivery models that make a strong business case and encourage interoperability, such as value-based fee-for-service and alternative payment models, and support for private-sector standards.
For usability, the recommended future role of government is for Centers for Medicare & Medicaid Services and Office of the National Coordinator for Health Information Technology (ONC) to reexamine current health IT regulatory requirements (especially those related to Medicare and Medicaid) and reduce or eliminate provisions that increase provider burdens or hinder usability. ONC and the National Institute of Standards and Technology should encourage usability standards and best practices to be developed and shared, including those that enhance health IT usability and reduce provider burden.
“Nearly 10 years after the passage of the HITECH Act, the time is now to update the course of federal health IT policy,” said the report. “Congress and the administration have an excellent opportunity to build a better system that fosters a free market, with competition and incentives that produce innovative tools that ultimately help providers and patients deliver and receive high-quality, efficient, and effective care.”