ONC’s Don Rucker at AHIMA17: Blockchain ‘not there yet’ for regulation

Don Rucker, MD, head of the Office of the National Coordinator for Health IT (ONC) said his agency has been focused on improving usability and interoperability of electronic health records, adding that while blockchain technology may provide some interesting capabilities but it’s too soon to issue regulations on it.

In his speech at the 2017 American Health Information Management Association (AHIMA) conference in Los Angeles, Rucker said there’s consensus among regulators and the healthcare industry that the problems with health IT stem from a lack of interoperability and usability issues which create an additional burden on providers. Usability, he said, could be improved by HHS’s focus on reducing regulatory burden under the Trump administration, though he cautioned that deregulation wouldn’t be done for its own sake.

“They were all put in for good reasons,” Rucker said of existing regulations. “They were put in to be good stewards of our tax dollars.”

On interoperability, Rucker said the need is clear, as enabling the kind of consumerism in healthcare to help patients make the best use of more prevalent high-deductible health plans means they need better access to their data. The agency was thinking about different scenarios for this, like allowing patient access to their medical records on their smartphones without having to first go through a provider portal.

In terms of regulations, the onus will come from the agency’s implementation of the 21st Century Cures Act. The law, passed with broad support from both parties late in 2016, requires ONC to define interoperability, information blocking and open application programming interfaces, or APIs. Having more precise definitions will be the first step to providing better data sharing, both from provider to patients and provider to provider, including in population health management.

“I think we’re going to have a real explosion in quality in America because of these computational things,” Rucker said.

Cybersecurity will remain a priority for the agency, Rucker said, when asked by a member of audience about whether efforts to limit information blocking can create new vulnerabilities in privacy and security. He also mentioned further work prioritizing data standardization and patient matching.

He also touched on one of the hotter topics in the health IT space: blockchain technology. Its promise—allowing users to send and receive data from multiple outside sources using an open and continuous secure online database which cannot be changed—is “very robust,” Rucker said.

Despite bullish predictions about blockchain’s rapid adoption in healthcare, however, Rucker said it’s not a top priority for ONC.

“It not there yet that we’re going to put that into a regulation in the coming year in our Cures Act work,” he said.