Overview

Learn How to Get The Most From Multi-Stakeholder Initiatives in Healthcare

Multi-Stakeholder Initiatives (MSIs) work in virtually every business and social sector to achieve such far-reaching goals as igniting and driving innovation, broadening markets and improving their performance, diminishing socioeconomic disparities and furthering equity, and advancing information sharing and interoperability.

In early 2022, Executives for Health Innovation (EHI) formed a Public Health Modernization Task Force in which EHI members with public health expertise came together to form policy recommendations to help build and sustain a modern public health system.

Report Overview The many barriers and delays faced by the nation as the COVID-19 pandemic took hold in early 2020 should serve as lessons learned; if we wait to modernize and adequately fund public health activities until there is another crisis, it will be too late. Policymakers must act swiftly to enact meaningful reforms to ensure we are better prepared for the next public health threat. While there are many problems with the current system to be explored, the Task Force report focuses on areas related to technology and data, given EHI’s focus on digital health and innovation. Through this lens, we focused on two main problem areas that help define the needed changes: fragmented and outdated systems.

The healthcare and public health sector is considered a critical infrastructure sector. As such, it is essential that the industry maintain robust cybersecurity protections. While the majority of the industry is privately owned, the federal government plays an integral part in the cybersecurity efforts by coordinating efforts across industry partners, such as with the National Health Security Strategy.

Please see the letter below for EHI’s responses to the specific questions in the request for information (RFI) to help shape the 2023 – 2026 National Health Security Strategy.

Overview Since the early 2000s, the Health Insurance Portability and Accountability Act (HIPAA) has been the nation’s primary health privacy law, protecting patient data held by the healthcare system – hospitals, doctors, clinics, and health insurers. With the explosive proliferation of digital technologies, an ever-increasing amount of health data is generated by consumers themselves. This data is both held and used by companies that are not bound by the obligations of HIPAA, leaving that data largely under-protected and under-regulated. With the generous support of the Robert Wood Johnson Foundation (RWJF), the Executives for Health Innovation (EHI, formerly the eHealth Initiative) and the Center for Democracy & Technology (CDT) released the Consumer Privacy Framework for Health Data (the Framework) in February of 2021.  The Framework outlines the current gaps in legal protections and discusses how non-HIPAA-covered health data should be used, accessed, and disclosed. A second round of funding from RWJF led to the development of two follow-up reports, The Case for Accountability: Protecting Health Data Outside the Healthcare System, authored by EHI, and Placing Equity at the Center of Health Care & Technology, authored by CDT.

The Final Report
EHI’s report makes the case for why a robust accountability mechanism is needed to govern the use of health data held and used by health tech companies. In the absence of new federal data privacy legislation, EHI has put forward a private-sector solution – a neutral, independently run self-regulatory program that will oversee the data use policies and procedures of Framework members.

Self-Regulatory Program
In January 2022, EHI launched a Request for Proposals from organizations interested in housing and running the Framework’s self-regulatory program. After careful consideration of the proposals submitted by an independent, objective committee of experts, EHI is delighted to announce that it has selected BBB National Programs to implement and house this new program, overseeing compliance with the Framework and protecting consumer health data not bound by the obligations of HIPAA.

1) A modern value-based, technology-enabled health care system creates better health care outcomes for everyone. eHI supports a value-based health care system that enables providers to deliver individualized care when and where patients need it, improve outcomes, and lower costs.

Virtual Care & Remote Patient Monitoring

• Permanently remove Medicare telehealth reimbursement restriction
• Promote cross-state provider license portability
• ​Remove barriers to the on-going utilization of remote patient monitoring devices
   

2) Digital health tools can be powerful tools to identify and address health disparities and promote health literacy. A variety of social and systemic factors have the potential to impact overall and individual health status. Health care providers and organizations should have access and effectively use digital health tools to identify and work to mitigate factors that lead to health disparities. Public policy must focus on addressing systemic causes of health inequity and allow health care providers to fully leverage digital health tools to combat individual health disparities faced by their patients. Policies should also seek to ensure these tools do not exacerbate existing biases. Additionally, policy should promote equity in access to digital health tools for both providers and patients and focus on ensuring that the design and implementation of digital health enables all levels of digital and health information literacy to benefit.

Broadband

• Support & expand FCC COVID-19 Telehealth Program
• Support high-speed broadband infrastructure funding

Digital health literacy

• Establish funding for digital health literacy programs through FQHCs/RHCs/CHCs

Data collection & exchange

• Support the development and adoption of health IT standards around the collection and exchange of social determinants of health data
   

3) Patient health information should be easily and securely accessed, exchanged, and shared electronically. eHI supports eliminating the practice of information blocking and allowing for the free and secure access, exchange, and use of health information. In order to advance modern approaches to interoperability, eHI supports the responsible and secure use of standards-based application programming interfaces (APIs) by all applicable stakeholders to enable effective, authorized access to health data by patients, their authorized representatives, providers, payers, researchers, and others authorized to access such data.

Interoperability

• Support implementation and enforcement of information blocking and interoperability rules, as well as continued education for those subject to regulations
• Support secure, standards-based approaches to interoperability and information sharing
   

​4) Patients should be confident that their data is secure and protected – regardless of who controls the data. eHI believes Congress must pass comprehensive data privacy legislation that reflects how data flows in today’s health care ecosystem.

Federal privacy legislation

• Support comprehensive federal data privacy legislation that meaningfully addresses gaps in legal protections for health data outside HIPAA’s coverage
• Advocate that bills related to collection and use of Covid-tracking data emphasize patient education and privacy

Implementation of existing regulations

• Ensure CMS/ONC interoperability rules are implemented in a way that takes burden off of both providers and patients
• Ensure the HIPAA proposed rule is finalized in such a way that increased information sharing doesn’t also result in increased risk of privacy violations 
   

5) Public health systems should be modernized and adequately funded. The COVID-19 pandemic has highlighted the need to modernize current public health surveillance and reporting systems. eHI supports efforts to promote the electronic sharing of public health information and provide predictable and adequate funding to ensure this goal can be accomplished.

Public health modernization

• Monies appropriated for public health system modernization should be used to support ensuring public health systems are interoperable with clinical data sets, allow for the electronic exchange of health information, and improve public health surveillance systems

Public health funding

• Restore and protect funding for the Public Health & Prevention Fund