In February 2020 the Office of the National Coordinator for Health Information Technology (ONC) released its final report on the Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs as mandated by the 21st Century Cures Act.
The report is divided into the same four major sections as the version released for comment back in 2018 (see our previous blog), each covering a different area: clinical documentation; health IT usability and the user experience; EHR reporting; and public health reporting. For each section, the report briefly lays out the issues and challenges and provides some key strategies and recommendations.
As before, the final report does a nice job of discussing and identifying the challenges and opportunities for data exchange between Federal agencies, and between clinical care and the Federal government, but it fails to recognize that state and local reporting represents the vast majority of the interoperability between public health and clinical care. Perhaps this narrow focus is a function of the mandate of the workgroup to focus on Federal programs.
Much of the public health section in the final report focuses on substance abuse issues: Prescription Drug Monitoring Programs (PDMPs), and confidentiality of substance use disorder health information. The workgroup that worked on this report focused almost exclusively on these issues. While the final report does include a reasonable discussion of barriers to more consistent public health reporting, the action item coming out of these issues is an inventory of data exchange between Federal agencies, and between clinical care and the Federal government. Given that public health reporting is almost all at the state/local level, reporting to the Federal government is largely incidental and such an inventory would likely have limited usefulness and little impact on the barriers to clinical interoperability with clinical care.
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