ONC's Don Rucker says Interoperability Ruling is 'Coming Relatively Soon'

Issues are 'complicated,' and it's necessary to balance the needs of multiple stakeholders.

Waiting on pins and needles for the final ruling of the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program?

It's complicated, said National Coordinator Don Rucker, MD, of the Office of the National Coordinator for Health Information Technology (ONC), this morning during a regularly scheduled meeting of the Health IT Advisory Committee, but confirmed, "It's going to be coming out relatively soon."

The proposed rule, which was announced over a year ago and is designed to give patients access to information that resides inside their electronic health records (EHR), is governed by the Administrative Procedures Act, which prohibits anyone from releasing information about when the rule is finalized, said Rucker.

"Technically we're not allowed to say when the rule is out," he said during the meeting. He referenced "D.C. gossip sites," which have been stirring speculation about the impending release date.

"These are complicated issues," he said, noting that it's imperative to balance the interests of the American public, clinicians, healthcare transparency, and innovation.

Related: Special Report: Epic Uproar Exposes Conflict Between Data Privacy and Innovation

"[We need to] draw the right balance on protecting privacy, yet address what is ultimately the biggest issue, which is simply the vast amount of healthcare costs that are out there and the lack of patients having agency," said Rucker.

"I would say we're making very solid progress in getting the rule out," said Rucker. "It's a process [that] involves a whole bunch of people. I know it looks like a black box from the outside, but there's a whole bunch of folks involved."

A second proposed rule, Interoperability and Patient Access, was issued by the Centers for Medicare & Medicaid Services (CMS) last year and is considered a companion piece to the ONC proposed ruling. It was delivered to the Office of Management and Budget on September 26, 2019. It may languish there for a while, as it has been earmarked for "long-term action," with a deadline that could be as late as March 2, 2022.

Last year the proposed rulings were released to time with the Healthcare Information and Management Systems Society (HIMSS) annual conference. Rucker has been invited to speak during the HIMSS conference this year, scheduled March 9‒13 in Orlando, along with HHS Secretary Alex Azar and CMS Administrator Seema Verma. None have confirmed their appearance.