The healthcare hubbub that Epic Systems started in January with an email from its CEO and founder, Judy Faulkner, to several of its hospital and health system clients has continued in February.
The tactic did not go unnoticed, and scathing responses were handed down by two of the industry’s leaders, and several other industry insiders, including Microsoft, Google and Cerner. Still, more than a month on, the piling on continues.
The latest comment is from Donald Rucker, M.D., head of the Office of the National Coordinator for Health IT (ONC). The proposed interoperability rule from the ONC, he said, is "solid" for patients’ data privacy protections.
Rucker also said privacy in the modern, technological age is challenging, but patients should be able to easily access and share medical data.
But Rucker’s comments carried more weight than just admonishment of Faulkner’s missive. Speaking at Health Datapalooza in mid-February, he went even further and took on those who signed on with Epic’s lobbying efforts in opposition of the rule’s current language.
The letter Faulkner sent was signed by more than 60 hospital and health system CEOs, according to reporting from CNBC. The letter cited risks to patient privacy and intellectual property if the rules are finalized now.
Rucker said the hospitals that signed the letter because of their so-called privacy concerns but don’t share the same sympathy for patient privacy when unpaid medical bills are a factor.
"One of the signers of the letter is known for taking thousands of patients to court. If you take someone to court, that information becomes public discovery. Their medical care is now public. It's part of the court record," he said. "Looking at protecting privacy, we need to walk the walk here as we look at who is saying what and letter-writing campaigns."
"We've often looked at interoperability in a narrow view, which is just as a replacement for moving the patient’s chart. Modern computing and APIs offer a vastly richer and more empowering global computing environment. Well-built APIs can do almost anything that your creativity allows," he said.
Before Rucker took the stage at Health Datapalooza, Health and Human Services (HHS) Secretary Alex Azar also addressed the upcoming interoperability rules and the Trump administration's commitment to putting "patients in charge of their data" and called out industry stakeholders who are "defending the status quo." They are protecting a health records system that is "segmented and Balkanized," he said.
"We have a serious problem — and scare tactics are not going to stop the reforms we need," Azar said.
Prior to this recent volley of assaults from the federal health IT’s leaders, a bigger gun took aim. Seema Verna, administrator of the Centers for Medicare and Medicaid Services (CMS), called Epic and Faulkner “bad actors” for opposing the rule.
In a presentation at the 2020 CMS Healthcare Innovation Industry Day in Washington, D.C., Verma minced no words: “Access to one's data can be a matter of life and death, and this administration will not waver in ensuring that patients enjoy full ownership of their data.”
"The disingenuous efforts by certain private actors to use privacy, as vile as it is, as a pretext for holding patient data hostage is an embarrassment to the industry," Verma said. "The short-sightedness of such efforts is deeply troubling considering the broad frustration of the American people with the status quo, and it's the fuel that is driving the calls for the destruction of the entire private healthcare system.”
Two interoperability proposals, released by the ONC and the CMS in 2019, make up the core of the Trump administration's vision for putting patients at the center of American healthcare.
The rules, as designed, make it easier for providers, insurers and patients to exchange health data by requiring caregivers or health systems and insurers to implement standardized application programming interfaces that connect IT systems like electronic health records with third-party apps.
