HHS official wants ‘single, unified’ EHRs for Americans

John Fleming (Gage Skidmore / Flickr)


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Americans should have a single, cloud-based electronic health record that follows them throughout their lives from doctor to doctor, a top tech policy official at the Department of Health and Human Services said Friday.

“I believe every American should have a single, unified electronic health record system that resides in the cloud and is under full control of the patient, of the individual, of the American,” John Fleming, HHS deputy assistant secretary for health technology, said at a Georgetown Law event.

Fleming, a Republican who represented Louisiana in the House before taking his post in March, believes that doctors should have their own versions of a patient’s record, but the patient should own it and have easy access.

“You go from Dr. A to Dr. B, and how do you get that information that’s maybe accumulated over the many years? And how do you get it in a format that’s easy for that doctor to use?” he questioned.

Fleming added: “That’s a big challenge, but think about the benefits of that, that each time you go to a provider, the new information is pushed back up to the single, unified health record.” But “of course that creates more challenges when it comes to security and privacy.”

That level of record transfer from physician to patient to physician, though, isn’t possible without progress first in interoperability between different electronic health record systems.

A major challenge, Fleming said, is “machines talking to machines, being able to transfer data when we want and how we want … it’s not going to happen over night. We have many technical challenges to why that can’t be done.”

“We go to the internet and you have Apple talking to Microsoft,” he said. “Well in the world of health care records, it just doesn’t work well at all.”

In his role at HHS, Fleming works within the Office of the National Coordinator for Health IT, which has made tremendous progress in the pat decade creating a national framework for interoperability, combating challenges like information blocking between proprietary vendors.

Fleming said the office will continue that focus under the new administration — one that in its budget proposal for fiscal 2018 said it wants to cut ONC funding by 36 percent — without being overly “prescriptive” in its leadership.

“[W]e’ve got the world’s experts, in some case, tackling [interoperability],” he said. “But I am convinced that someday we will solve that problem.”

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Department of Health and Human Services (HHS), electronic health records (EHRs), Health IT, John Fleming, ONC