Apps provide ‘rich’ opportunities for data security, ONC’s Rucker says

Apps will catch on as a dominant way patients seek access to their medical data, since—unlike existing technology—they're designed with patients in mind, the Trump administration's top health IT official said Tuesday, reaffirming a vision behind recent interoperability and information-blocking regulations.

The rules from CMS and HHS' Office of the National Coordinator for Health Information Technology, released in March, will require healthcare providers and insurers to adopt technologies that will let patients download their medical data onto mobile apps.

"We have almost everything on our smartphones—banking, sports, travel," ONC chief Dr. Donald Rucker said during a two-day virtual summit hosted by DirectTrust. "I mean, are there any airlines where you can't log on and book flights?"

Once given the option to use apps to access and manage one's medical data, consumers will begin to expect it in healthcare, too. "This will be just a condition of doing business," Rucker said. "That will be the expectation of care."

It's left to be seen whether patients will take advantage of the capability to download their medical data onto apps; early projects exploring the concept have had mixed success. And patients haven't rushed to access their medical data with existing tools, such as patient portals.

In 2018, just 30% of patients who were offered access to an online medical record chose to view it, according to a data brief from the ONC.

Still, Rucker said he envisions apps could outpace patient portal adoption, since they'll be designed with convenience for patients in mind.

Rucker acknowledged that patient portals were "state of the art" not too long ago.

But portals, "just because of the technology that was available, are at the provider's convenience," he said. "As patients and as citizens, we want stuff at our convenience."

Smartphone apps also provide "richer ways to provide security (and) richer ways to do authentication," Rucker claimed.

A key concern with linking up patients' health records to mobile apps has been data privacy, since app developers are not held to as stringent privacy requirements as healthcare providers and insurers. The American Hospital Association, American Medical Association, technology groups and privacy advocates have expressed concerns moving medical data to apps could leave sensitive patient information in jeopardy.

Rucker stressed that patients would be able to authorize which types of data they want to share with a selected app, and that providers will be able to set up warnings to alert patients that data that's transmitted will not be covered by such privacy rules as HIPAA.

"We believe that will provide powerful protections for patients," he said.

Rucker also expressed support for flexibility CMS has put into place for telemedicine during the COVID-19 pandemic, such as the agency's temporary expansion of Medicare reimbursement. Telemedicine flexibilities, like the interoperability rules, point to the Trump administration's ongoing focus on cutting down on regulatory barriers, he said.

"I think we have—in the last several months—made extraordinary progress on building this much more modern, much more consumer-friendly, world," Rucker said.

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