ONC, FDA aligning app guidance with broader health IT policy


The Office of the National Coordinator for Health IT has taken a leadership position in promoting the implementation of health IT across the country. ONC is actively supporting the adoption of health IT and the promotion of nationwide health information exchange to improve America's healthcare system. FierceMobileHealthcare had the opportunity to speak with Jodi Daniel, Director of ONC's Office of Policy and Planning. 

In that capacity, Daniel, who is a lawyer by training, is responsible for thought leadership, policy development, and identifying "policy levers" for health IT activities, including establishing new policies and working with other federal agencies and private organizations to coordinate efforts regarding adoption and health information exchange. 

In addition, FierceMobileHealthcare was able to talk with Kathryn Marchesini, a senior analyst and advisor to ONC's chief privacy officer on issues of privacy and security related to mHealth. Marchesini, who is also an attorney, helped to address some of the challenges in securing mobile devices and highlighted the office's activities in this area.

FMH: ONC is supporting the adoption of health IT and the promotion of nationwide health information exchange to improve healthcare. But, what about mHealth?

Daniel (right): You're right, we support health IT adoption. mHealth is a type of technology that is a part of health information technology, as I see it. It's a type of technology that can support health and wellness, which is our goal, as well as to improve health and healthcare. As more folks are using mobile technology and devices, mHealth can be an effective way of using technology to support these goals. So, we see it as a subset of the activities that we are focused on.

Mobile is obviously where computing is going. It's powerful. It's a way of reaching a large number of people in their daily lives. And, it supports the scalability of health information, which is something that we are trying to promote to make sure that it is available where and when it is needed. Within the scope of our mission, it's something that we're both paying attention to, making sure our policies are supportive of, and thinking about how we might be able to leverage that shift in our work, our policies, and our guidance. I don't see it as a separate and distinct thing. I see it as part of the broader scope that we have. 

FMH: Do you see a role for mHealth in electronic health records, perhaps in Meaningful Use Stage 3? For instance, will Stage 3 encourage medical practices and hospitals to enlist their patients to use health devices and apps, and to accept patient-generated data into EHRs?

Daniel: When we establish the criteria and standards for certifying EHR technology, we don't specify what kind of tools can be used to represent those functionalities. We know that some EHRs are providing mobile platforms for providers. So, our role doesn't necessarily call out mobile health but I don't think that it precludes the use of mobile health either. Folks can figure out the best ways of developing, certifying and implementing EHR technology and making tools available to providers that help support them in Meaningful Use of the technology.

The one thing I will say is for Stage 3 there have been conversations among our Health IT Policy Committee, our advisory committee which makes recommendations to ONC, about patient-generated health data and how information that individuals collect may be made available to clinicians through certified EHR technology. That's something that we're awaiting input and recommendations on from them as to whether that is something that we could or should include in Stage 3. Patient-generated data is something that we are paying close attention to and understanding whether there are some areas where we may want to encourage providers to accept information directly from patients, captured from mobile technology or some other means.