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Tuesday, June 6, 2017

Should we abolish the ONC?

"The Office of the National Coordinator for Health Information Technology (ONC) is the lead agency charged with formulating the federal government’s health information technology (IT) strategy and coordinating federal health IT policies, standards, programs, and investments. ONC supports the Department’s goal to strengthen health care by modernizing the care delivery infrastructure of the nation through the adoption, implementation, meaningful use, and optimization of health IT.

The FY 2017 Budget for ONC is $82 million, $22 million above FY 2016. This Budget reflects ONC’s commitment to advancing progress towards a safe and secure nationwide system of interoperable health IT that focuses on safety and usability. Through the engagement and collaboration of public and private sector stakeholders, ONC will facilitate care delivery transformation and better health and health care nationwide.

In FY 2017, ONC will focus on encouraging market transparency and competition, improving electronic health record usability, and offering technical assistance to providers to help them get the most out of their health IT."
In light of my prior post.
Go to Search around for "eClinicalWorks" (including via the "Newsroom" link). See if you find any mention of the eCW fraud.

First "Newsroom" hit (which ranks eCW at 3rd):
Health Care Professional EHR Vendors
Certified Health IT Vendors and Editions Reported by Ambulatory Health Care Professionals Participating in the Medicare EHR Incentive Program

Note: Certified health information technology (health IT) meets the technological capability, functionality, and security requirements adopted by the Department of Health and Human Services. The order above reflects vendors of commercial certified health IT only; totals for self-developed certified health IT are summarized as a whole. 2014 certified health IT is certified under the 2014 Edition Health Information Technology Certification Critiera, and 2011 certified health IT is certified under the 2011 Edition Health Information Technology Certification Criteria...
"Certified health information technology (health IT) meets the technological capability, functionality, and security requirements adopted by the Department of Health and Human Services."

Unless it doesn't.

ONC "$82 million" budget this year? That'd perhaps pay for Trump's 2017 weekend trips to Mar-a-Lago. That's less than HIMSS recent annual gross (~$97 million, per their IRS Form 990 via Guidestar). Hey, Donald, while you're privatizing the FAA, why don't you sell off ONC to HIMSS? They just bought Health 2.0. We could have one Big Happy Free Market HIT Family.


From Health Affairs,
Across all medical specialties, there is a severe lack of high-quality clinical evidence, in part because the gold standard for evidence is large-scale randomized controlled clinical trials. Such trials are on an unsustainable cost trajectory, as they require expensive, stand-alone data capture infrastructures. Furthermore, they typically enroll highly selected populations that are not necessarily representative of real-world patients. Although the emergence of the electronic health record (EHR) holds great promise for generating much-needed evidence, medical research lags far behind other industries in its ability to use big data to get the answers decision makers need in health care. The ability to harness good quality, usable data from EHRs will likely be as revolutionary to health care as the Internet was to other industries.

The problem is complex, and one facet of the issue is that data from health systems are not interoperable; for example, information such as date of birth, blood pressure, or diagnoses can be recorded in a myriad of ways. Although the Centers for Medicare and Medicaid Services encourages and incents “meaningful use” of EHRs, these systems are customizable to each institution’s needs, and as a result, data from individual health care systems and providers are housed in silos of babel—with limited ability to exchange information between them. Compounding the issue, most organizations erected proprietary systems of digital health data capture before standardized formats were developed and before thoughtful consideration about reuse of these data for research activities gained traction. As a result, it has been infeasible to ask questions as seemingly simple and important as “Which dose of aspirin is associated with better outcomes?”
To counter these problems, the Patient-Centered Outcomes Research Institute (PCORI) funded PCORnet, the National Patient-Centered Clinical Research Network, to support clinical research. PCORnet has built strong partnerships between clinical researchers and patient advocacy networks. In addition, PCORnet has established a Common Data Model to support pragmatic trials and observational research. Use of PCORnet’s Common Data Model will enable large-scale clinical research from data gathered during patient care as well as rapid execution of queries. Data can be collected and harmonized across more than 130 diverse organizations representing more than 122 million individuals who had a medical encounter in the past five years. Additionally, 41 million patients are available for enrollment in clinical trials and other studies...
PCORI was legislated as part of "ObamaCare" (PPACA), not HITECH, btw. If the GOP actually goes through with ACA repeal, PCORI will go down the tubes as well.

More to come...

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