The broader goals of the MyHealthEData initiative announced by CMS at HIMSS18 have the support of Vice President Joe Biden, but he also criticized the Trump administration for a lack of specifics on the proposal and put the blame for the lack of interoperability squarely on the healthcare industry.
In an op-ed in Fortune, Biden went over Obama administration's efforts to push use of electronic health records (EHRs) beginning with billions in funding in 2009’s American Recovery and Reinvestment Act. By 2015, during Obama’s second term in office, EHR adoption had increased to 87 percent of physicians, with 78 percent reporting using a Certified EHR system.
What held back the “promise” of EHRs, Biden argued, is the industry itself.
“Medical record companies and health providers have implemented systems that are not interoperable,” he wrote. “Many would say this was done on purpose because it meant they could lock up customers by making it time consuming and expensive to change systems. And even worse, they made it very difficult (sometimes impossible) for patients to get their own data quickly, cheaply, and in an easily accessible digital format.”
Biden said the Obama administration tried to address these issues through the original Blue Button program (now being advanced by Trump’s CMS to Blue Button 2.0, a move Biden supports) and the “Sync for Science” pilot program to allow patients to send their health data to researchers working on the Precision Medicine Initiative.
“The industry has had ample opportunity to voluntarily address the issues of interoperability and putting data in patients’ hands, and they have not done so,” Biden wrote. “Now is the time to do something about the data siloes they have created—to improve health and extend lives.”
To do that, Biden said the current administration has to be more specific. His own principles on data sharing are similar to what CMS Administrator Seema Verma, MPH, laid out at HIMSS18, such as giving patients easier access to data and breaking down data siloes while keep patient information secure. But he also went beyond Verma’s statements, such as calling for an information blocking standard which would punish providers which don’t give patients their full medical record in electronic form within 24 hours of a request.
He also proposed a “uniform patient data portal” be developed by Center for Medicare and Medicaid Innovation (CMMI), getting rid of “disparate formats” and taking the data storage solution away from vendors.
“The technology exists to do this, and those receiving benefit through federal programs should have access to the best in practice—not only could it improve outcomes, but it would reduce reimbursement costs for CMS,” Biden wrote.
In one suggestion closer to what his post-government work leading the Biden Cancer Initiative, he proposed HHS work on expanding the Sync for Science program, with the help of leading EHR vendors like Epic and Cerner, by allowing new groups of patients to opt into the program and contribute their records to research projects.