Biden’s Era of Interoperability

President Biden took office on Jan. 20 with an aggressive 100-day to-do list. Healthcare, and more specifically coronavirus control, are top priorities, but the role of interoperability and the secure access and exchange of health information remain underlying critical components that will contribute to or foil the success of these initiatives.

In a statement from Biden’s administration, a common theme to measure progress is to “harness the full power of science and technology on behalf of the American people.” And, we have learned, we cannot have effective healthcare on either an individual or a national basis without interoperability technology.

Continuing Momentum

The Office of the National Coordinator for Health IT (ONC) announced new rules in March 2020 to prevent information blocking and to help patients more easily access their data in order to fuel new digital innovations. Interoperability has proven to be an important innovation in healthcare that has gained acceptance across party lines.

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It was during President Biden’s time as Vice President in 2016 that the bipartisan 21st Century Cures Act was signed into law to, among other things, advance interoperability and adopt electronic health records to collect data for research and care. There has been significant effort and attention on this since 2016, and this is expected to continue.

President Biden also plans to expand the Affordable Care Act (ACA), promote additional enrollment, and increased value-based care payments to “give Americans more choice, reduce healthcare costs and make our healthcare system less complex to navigate.”With the reinforcement of ACA, we may expect to see continued expansion of digital health apps to manage care, lower costs while improving quality, and empower patients to own and utilize their data to support care management.

New Leadership Offers Promising Indications

President Biden has not yet explicitly addressed the direction of health IT, but his selection of leaders in the new administration cast a strong indication. His most recent selections for the Department of Health and Human Services (HHS) are known to be strong advocates for interoperability, including Dr. Rachel Levine as HHS Assistant Secretary and Micky Tripathi appointed as the National Coordinator for Health IT.

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Dr. Levine is a strong proponent of interoperability with a keen understanding of the value it offers in supporting public health initiatives. During her tenure as Pennsylvania Health Secretary, and prior to that as the state’s physicians general, she was instrumental in leading interoperability of health systems in the state to be an example to the rest of the country.

ONC, a department under HHS, does not appear to be pausing interoperability efforts. Tripathi has self-proclaimed as “bullish” on driving interoperability and advancing the national health information technology framework, and his demonstrated background in health IT and participation in interoperability advocacy groups, such as The Sequoia Project, bode well for continued progress.

Info-Blocking Rules

In the spirit of carrying on business-as-usual, in January 2021, ONC released a draft of Version Two of U.S. Core Data for Interoperability (USCDI) to expand the core data classes and elements required for nationwide interoperable health information exchange. The update to USCDI includes a class designation for diagnostic imaging and required elements of diagnostic imaging narrative, orders, and reports among several other new data classes, such as care team and encounter information. While there have been compliance delays in recognition of the need to focus all resources on managing the pandemic, ONC is carefully expanding requirements so as not to stall efforts completely to increase access to critical clinical data.

2021 to Bring What 2020 Could Not

While the future of interoperability and digital health under the Biden administration remains to be wholly seen, so far, key indicators demonstrate that health data interoperability continues to gain momentum.

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