WASHINGTON, D.C. – With coronavirus topping Americans' concerns, senior Trump administration officials tried to switch subjects Monday by announcing final rules aimed at delivering on the unfulfilled promise of electronic health records.
It did not go smoothly as reporters veered back to the global outbreak increasingly affecting U.S. communities.
"The notion that we can't do our day jobs and work on this very serious issue (coronavirus) is absurd," said a frustrated Health and Human Services Secretary Alex Azar after one reporter noted that financial markets had opened sharply lower over fears of global economic damage from the outbreak.
Azar recapped administration actions to try to contain the spread of the virus in the U.S., develop tests, treatments and vaccines, work with local officials in areas that are seeing outbreaks, and care for the sick. Announcement of the technology rules was originally planned at a health care conference in Florida, but that event was canceled over coronavirus concerns.
The long-awaited rules could take several years for consumers and patients to start seeing the practical effects. They are intended to get at one of the major problems with electronic health records: the systems of hospitals and doctors often don't 'talk' to each other, and patients struggle to get their medical information digitally transmitted, defaulting to CDs and faxed paper records.
The federal government invested more than $30 billion a decade ago to help hospitals and doctors convert to computerized records. But it never solved the problems of getting the different medical systems to seamlessly interact, and of providing a pathway for patients to easily access their records. Two rules finalized by the Trump administration aim to finally fix that.
The regulations are highly complex. Hospitals and a consumer group objected, saying that patient privacy would be undermined.
One rule from the HHS agency that oversees health care technology would implement congressional requirements that hospitals and other health care entities put a stop to practices that can block the digital transfer of information. Some systems don't allow screen shots or video to be shared, for example.
The health care technology office rule also tries to address access problems at the patient's level. It requires hospitals and other health care service providers to allow access to records via software used by smartphone apps, such as the ones that already handle banking and credit card transactions. Patients could literally access their records via the smartphone in their back pocket.
A companion rule from the Centers for Medicare and Medicaid Services would require health plans in Medicare Advantage, Medicaid, “Obamacare” and the children's health insurance program to give patients access to their information through apps compatible with smartphones.
CMS will also require hospitals to electronically notify a patient's outside doctors when that patient is admitted, discharged or transferred.
The hope is that easier access and authorized sharing of individuals' health care information will help prevent medical errors, cut down on duplicative tests, and help patients become smarter consumers of health care services.
But Rick Pollack, president of the American Hospital Association, said a new generation of health care apps could put the personal information of patients at risk, since the app developers would not be required to meet the same legal standards for privacy that are imposed on hospitals. “This could lead to third party apps using personal health information in ways in which patients are unaware,” Pollack said in a statement.
The consumer advocacy group Public Citizen also criticized the new rules, saying they fail to guarantee that sensitive information won't fall into the hands of third parties that could exploit it for profit.
CMS says it intends improve on health care privacy standards in the smart phone industry to provide consumers with a higher level of protection.
In addition to Azar, among the top administration officials joining to make the announcement were White House health policy chief Joe Grogan, CMS Administrator Seema Verma, and Donald Rucker, the government's National Coordinator for Health Information Technology.
The administration's plan had been to make the announcement at a global health technology conference sponsored by the Healthcare Information and Management Systems Society in Orlando this week. But that event was canceled due to concerns about large gatherings where travelers can unwittingly spread coronavirus.
“Sorry we can't see you in Orlando, which was our original plan here," technology coordinator Rucker told reporters.
An earlier version of this story was corrected to show that the rule requiring patient information be available through smartphone apps came from the HHS technology office, not the Centers for Medicare and Medicaid Services.