HITAC sets up COVID task force to focus on tech issues impeding frontline clinicians

The Health IT Advisory Committee is standing up a coronavirus task force to tackle privacy and interoperability issues that are impeding frontline clinicians as they combat the growing outbreak.

HITAC co-chairs said during a meeting Thursday they plan to convene the task force in the coming weeks and would determine definitive charges for the group. The task force will begin soliciting participation early next week.

HITAC advises Congress and the U.S. Department of Health and Human Services on health IT policy.

National Coordinator for Health IT Donald Rucker, M.D. said ONC, an agency within HHS, needs to hear from frontline clinicians about what's working and not working and the resources they need. 

"The information that we get is filtered here in D.C. and it's filtered through commercial interests and commercial spins. It's helpful to hear directly from folks on the front lines and actually providing care about what they need. If it could serve as an early warning system about things coming up, that's what is needed," Rucker said.

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The HITAC task force will likely focus on issues and challenges around privacy, data standards, data interoperability, and infrastructure, said Robert Wah, M.D., co-chair of HITAC and former chief operating officer at the ONC.

Committee members brought up a range of issues that the health IT community can help tackle including COVID-19 clinical decision support, supporting increased telehealth activity, taking a look at HIPAA enforcement and data sharing rules, and improving electronic case reporting.

One major challenge fading frontline clinicians is an inability to quickly share information as the outbreak quickly evolves, according to many committee members.

Many clinicians and health IT leaders are relying on social media, especially Twitter, to exchange information about the latest research or to share anecdotal evidence about early indications of COVID-19, said Aaron Miri, a member of HITAC and chief information officer at the Dell Medical School and UT Health Austin.

Christina Caraballo, director of Audacious Inquiry, said frontline clinicians don't have time to research the latest technology tools and innovations.

"It would be extremely valuable for them to know how IT can be deployed quickly and what is working now and what is available,' she said, noting that ONC can serve as that resource for healthcare providers.

"There are things we can do immediately to get a leg up and empower clinicians to be successful," Miri said.

Committee members suggested that ONC can leverage its existing role as a coordinator for healthcare technology across different federal agencies.

ONC could work with the Federal Communications Commission to address bandwidth issues as providers ramp up the use of telehealth and to reserve bandwidth for first responders. ONC also could collaborate with the Office for Civil Rights to provide guidance related to HIPAA and data privacy issues and with the Centers for Disease Control and Prevention on disease tracking, committee members said.

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As government agencies weigh the use of tracking and surveillance technologies to better track the virus, such as geolocation data from smartphones, it raises serious privacy issues that the health IT and healthcare communities will need to tackle.

Relaxing privacy regulations to better access or share data, specifically location data, would help public health officials more effectively track the virus, noted Clem McDonald, M.D., member of HITAC and director of the Lister Hill National Center for Biomedical Communications at the National Library of Medicine.

Carolyn Petersen, co-chair of the HIT advisory committee and senior editor for the Mayo Clinic’s health information website cautioned that the industry needs to balance public safety and personal privacy.

"The things we do today, as far as relaxing regulations on patient consent and notification on when personal health information has been shared, will have long-term implications for patients and the healthcare system," she said.

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Health IT leaders can focus on processes like data segmentation for privacy to share COVID-related information in order to facilitate patient care without relaxing regulations, she noted.

There is an existing data-sharing infrastructure through organizations like CommonWell and Carequality that can help support disease surveillance and identification of virus risk factors, Miri said.

State and regional health information exchanges (HIEs) also have the capability to share valuable data such as COVID-19 test results and hospitalizations, noted John Kansky, president and CEO of the Indiana Health Information Exchange. 

Temporarily designating HIEs as public health authorities during the pandemic would enable the organizations to more quickly pull in data from more sources, Kansky said.