The announcement Tuesday, March 4 that Seema Verma, Administrator of the federal Centers for Medicare and Medicaid Services (CMS), had just appointed a new Chief Healthcare Informatics Officer (CHIO) in the Office the Administrator (Verma herself), was a fascinating one on numerous levels. And that appointment—of Dr. Mark Roche, had previously served as a physician advisor in the Office of the National Coordinator (ONC), another agency within the Department of Health and Human Services (HHS).
In her announcement to CMS staff on March 5, Administrator Verma wrote, “Colleagues, I am pleased to share with you several staff additions and changes that together will help CMS deliver on its strategic initiatives. Dr. Mark Roche also began this week as the new Chief Healthcare Informatics Officer in the Office of the Administrator. In this role, he will be responsible for helping formulate and implement the clinical and technical aspects of CMS’ interoperability strategy and MyHealthEData initiative. Mark is a physician informaticist with over 16 years of experience working in government, academic and industry sectors on initiatives such as national eHealth strategy, data modeling and semantic interoperability. He formerly served as a physician advisor to the Office of the National Coordinator (ONC) for Health IT where he led the design of U.S. Interoperability Roadmap, and developed components for 2015 E-Certification Rule and electronic Clinical Quality Measures (eCQMs) in support of CMS’ Meaningful Use Stage 3 program (Promoting Interoperability program).”
So, to begin with, it is interesting that Dr. Roche will be reporting directly to Administrator Verma at CMS, even as Donald Rucker, M.D., National Coordinator for Health IT, has a full staff of informatics experts and leaders at ONC, including several with medical or clinical informatics backgrounds. But of course, ONC has a different role, and a different mission, from CMS, its much, much larger sister agency under the HHS umbrella.
As Administrator Verma has made it clear in numerous statements and appearances, she is determined to empower patients/consumers as stakeholders in healthcare delivery and payment (through their ability to choose providers), by giving them direct access to their records and health information, as located in electronic health records (EHRs) and in files kept by health insurers. Indeed, in a press briefing held on Monday, Feb. 11, as the HIMSS19 Conference was getting underway in Las Vegas (though the press briefing took place over the phone), Verma made several key points regarding the twin proposed rules that CMS and ONC had just released moments prior to the briefing, and which were intended to increase choice and competition while fostering innovation that promotes patient access to and control over their electronic health information (EHI).
During that press briefing, Verma said, addressing Deputy Secretary of Health and Human Services Eric D. Hargan, “I share your commitment to move towards a healthcare future where patients are able to obtain and access their healthcare information with just a few secure clicks. Together, these two ground-breaking rules will give [healthcare consumers] access to their data in a seamless format.” What’s more, she said, “Our nation is in the midst of the greatest healthcare challenge in perhaps our entire history. If nothing is done to curb our costs by 2021, we will be spending one in five dollars on healthcare.” She stated her firm belief that empowering healthcare consumers with their patient data could revolutionize the healthcare system, by encouraging them to investigate cost and quality information and to become more engaged in their patient care.
What’s more, in the press release that had just been published prior to that press briefing, Verma was quoted as stating that “Today’s announcement builds on CMS’ efforts to create a more interoperable healthcare system, which improves patient access, seamless data exchange, and enhanced care coordination. By requiring health insurers to share their information in an accessible, format by 2020, 125 million patients will have access to their health claims information electronically. This unprecedented step toward a healthcare future where patients are able to obtain and share their health data, securely and privately, with just a few clicks, is just the beginning of a digital data revolution that truly empowers American patients.”
So might the hiring of Dr. Roche as CHIO in Verma’s office at CMS, be connected, at least in part, to the release of the twin CMS and ONC proposed rules last month? I’d be the last person to suggest a direct and singular connection to the CMS and ONC proposed rules; at the same time, who within CMS is going to help Verma and her colleagues figure out the extent to which health insurers and providers are going to be doing what CMS has asked of them, when it comes to EHI?
It certainly would make sense to bring Dr. Roche into CMS, as that agency dramatically ramps up its demands on both health insurers and providers to provide patients with their PHI and to work with vendors to help truly interoperable and user-friendly APIs (application programming interfaces). It would also make sense with regard to having a clinical informaticist on board who could advise Administrator Verma and other senior CMS officials on some of the more technical aspects of executing on the demands they’ve put on both health plans and providers.
It would also make sense with regard to having someone who unofficially might be a “bridge” person between CMS and ONC, as both agencies ramp up their requirements on plans and providers. And it could even be helpful, as senior CMS officials evaluate the progress of APIs (application programming interfaces) over the next few years. After all, unlike ONC, CMS has not been a hotbed of healthcare information technology expertise—until now.
Of course, precisely how all this unfolds will be interesting going forward. Mark Roche’s is not a name that most in the industry have been aware of until now; who knows what kind of mark he might make on the current agency landscape? One thing is certain: this appointment shows that, at the very least, Seema Verma is well aware that executing on this next phase of mandates placed on industry stakeholders, will require assistance at a technical level that continues to intensify as the broad process of federal agency policy evolves forward over time.
