eHI tells ONC to take time with nationwide HIE

The Office of the National Coordinator for Health IT (ONC) should take its time to develop a carefully constructed governance mechanism for the Nationwide Health Information Network (NwHIN) with support from all of healthcare’s stakeholders, according to the eHealth Initiative’s response to an ONC request for information (RFI) on the topic.

An unsigned letter from the Washington, D.C.-based health IT advocacy organization, which represents many health information organizations across the country,  to ONC federal policy director Steven Posnack stressed that the ONC should diligently seek public comment before it begins developing regulatory and governance structures for the NwHIN.

“We recommend that ONC seek additional stakeholder input in the development of the framework for NwHIN governance,” the June 26 letter read. “Additional due diligence in the solicitation of public input, such as town hall meetings and forums, and additional solicitation of the perspectives from providers, will allow consideration of other public and private processes to support governance.”

The maturity of individual health information exchange (HIE) business models should be considered when constructing a timeline for the NwHIN’s development, as most have yet to reach critical mass. The timeline outlined in the RFI incorrectly presumes a higher level of maturity than actually exists, eHI suggested.

A future NwHIN governance structure should also take into account existing laws, regulations and initiatives at the state and federal levels to support systemwide redesign that is taking form in, for instance, accountable care organizations and patient-centered medical homes.

Additionally, the ONC should make an especially strong effort to build cooperation among the various organizations from all areas of both the private and public sectors, and to prevent future regulatory framework from becoming unnecessarily burdensome to providers.

“We believe that a governance framework for HIE must achieve a correct balance between guidance and flexibility, constraints and enablement, and regulation may not be the appropriate framework to achieve governance,” eHI said. “This balance is particularly appropriate given the developmental stages of some HIE initiatives.”

eHI's letter to Posnack is available in its entirety here.

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