HHS secretary: Cure law enforcement ‘long overdue’


US Department of Health and Human Services Secretary Xavier Becerra said the federal government has made “extraordinary progress” in the past year in advancing health technologies.

Becerra cited the launch of TEFCA, the application of the provisions of the Cures Act and the launch of the Helios FHIR accelerator to name a few examples.

At the same time, he told the annual meeting of the Office of the National Coordinator for IT Health this week, the agency has several goals that have yet to be met.

Among them is what he called the sentencing law enforcement gap.

Namely, as Becerra explained, civil monetary penalties for non-compliance with information sharing requirements have only been established for technology developers and health information networks.

“That left me with the vendor sanction: the secretary of the Department of Health and Human Services,” he said.

This is a problem, he noted, because more than 75% of complaints submitted to ONC were about providers — and most were from patients. Blocking information, he said, leads to stress for patients and families, as well as frustration for staff.

“This is not the kind of customer experience that any of us should expect, certainly not in the 21st century, from our healthcare system,” he said.

Simply put, he said, closing the enforcement gap is a “top priority for HHS, and we’re working hard on that right now.”

Another focus, he said, will be on health equity and public health, including through collaborative and participatory governance models.

He stressed the importance of what he called “health equity by design” at the ONC, aimed at integrating equity considerations into the design, development, implementation and use. This will include, at Becerra’s request, an “in-depth examination of algorithmic bias and its implications for health equity.”

National Coordinator Micky Tripathi echoed this goal in his part of the opening speech.

He noted the importance of ensuring the availability of usable data, including information regarding disability status, sexual orientation and gender identity. Consistency in reporting on race, ethnicity and language, he said, will also be a priority.

“The appropriate use of this data to address inequalities is also extremely important,” he said.

“You start with the data first and then you think about the uses of that data – how can it be used appropriately and effectively not just to make sure we don’t propagate or exacerbate the problems that exist in the system, but ideally to help rectify or mitigate some of those systems, using technology?” he added.

He also highlighted the role that electronic health records can play both in finding data to train algorithms and in conveying algorithm results to clinicians.

“Every algorithm can be biased, and how do you think about it systematically?” he said.

Lisa Lewis Person, Deputy National Coordinator, emphasized in the keynote that health IT cannot address all of the societal and institutional factors that contribute to health inequities. At the same time, she said, “it is critical that we mobilize health informatics to identify and mitigate disparities where they exist.”

Overall, “the exciting and inspiring part is that we get to think about how we want to redesign the healthcare system without the constraints of paper, bricks and mortar,” Tripathi said.

“When I took on this role 15 months ago, I promised several things: to be strategic, to be pragmatic, to be transparent, to be collaborative and to be impatient.

“I hope that all of you who are essential stakeholders feel that the ONC and I are up to all of these things,” he added.

Kat Jercich is editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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