ONC Will Not Create NwHIN Governance Rule

Press Release | The Office of the National Coordinator of Health IT (ONC) | September 21, 2012

The Office of the National Coordinator of Health IT (ONC) issued a Sept. 7 statement that it’s tabling its project to define governance for the Nationwide Health Information Network (NwHIN). ONC was pursuing the establishment of a formal rule that would provide a nationwide trusted information exchange service for health care delivery and ultimately create “rules of the road” for health information exchange.

As an alternative, ONC decided to implement a different approach “that provides a means for defining and implementing nationwide trusted exchange with higher agility, and lower likelihood of regret” without executing a formal rule.

The ONC feared that creating a formal rule governing the NwHIN would “slow the development of trusted exchange” rather than accelerate the process. Since the ONC currently is hastening the execution of a standards-based exchange in Stage 2 of Meaningful Use [see Washington Highlights, May 11], they do not want to risk slowing down any exchange developments.

Instead, ONC plans to identify best practices models and provide a framework of “enduring principles to guide emerging governance models.” Dr. Mostashari, national coordinator for health information technology, ONC, indicated the office also will “actively engage with entities currently serving in governance/oversight roles for specific groups of exchange partners,” to further promote good practice models. They also will continue their role as an authority and convening provider in order “to create consensus and provide guidance and tools around specific barriers to interoperability and exchange and continue evaluating consumer protections.

The HITECH Act ( P.L. 115-5) requires the ONC to establish a governance mechanism for the NwHIN, so they have a statutory obligation for governance; however, they do not have any mandate for regulation. Although some organizations such as the Certification Commission for Health IT (CCHIT), the eHealth Initiative (eHI), and the HIMSS Electronic Health Record Association (EHRA) argue that the NwHIN would be better served as “an independent public-private entity,” because they believe that this will create more trust in the agency and allow for a “multi-stakeholder representation.”

Presently, when a future governing structure will emerge for NwHIN remains unclear, and for now, ONC will continue its current role with NwHIN.


Rachael Gold
Health Care Affairs
Telephone: 202-828-0460
E-mail: [email protected]