Health Information Technology Policy

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June 18, 2025 – Patient engagement. Information blocking. Interoperability. These buzz words are flying around the health information technology (HIT) world as the Trump administration starts to make its mark on the HIT policy landscape. While the first months of President Trump’s second term provided clues about what HIT-related priorities this administration would focus on (and how it would go about achieving them), more recently, the administration has taken its first concrete steps. To help me describe these actions, I’m bringing in my colleague Kristen O’Brien.

One major question going into this administration was how the US Department of Health and Human Services (HHS) would treat the Office of the Assistant Secretary for Technology Policy (ASTP). ASTP was established towards the end of the Biden administration on July 25, 2024, encompassing the Office of the National Coordinator for Health Information Technology (ONC). The stated purpose was to expand the role ONC previously played within the department, given the importance of information technology to the department’s mission. Flashing forward to this administration, when Secretary Kennedy announced the HHS restructuring on March 27, 2025, the press release did not mention changes to ASTP. However, the president’s budget documents released in May 2025 announced HHS’s intent to establish a Chief Technology Officer (CTO), which will include the Office of the Chief Information Officer (OCIO), currently under the Assistant Secretary for Administration and the ASTP. CTO, through OCIO and ASTP, will lead and coordinate cybersecurity and other HIT efforts.

HHS’s goal is to move ASTP under the CTO’s purview, but in the meantime, Secretary Kennedy appointed Thomas Keane, MD, to lead ASTP. Keane is an interventional radiologist who previously administered the COVID-19 provider relief fund. ASTP, in conjunction with the Centers for Medicare & Medicaid Services (CMS), recently released a request for information (RFI) aimed at better understanding Medicare beneficiaries’ use of digital health products and the state of data interoperability and the broader health technology infrastructure. HHS also held an all-day listening session with key stakeholders on the future of HIT on June 3, 2025, shortly after Keane came on board.

The questions included in the RFI and the read-out from the listening session give us a sense of the direction HHS wants to go in and its potential next steps.

Listening Session

CMS and ASTP heard feedback from stakeholders during the listening session, but CMS also used the session as an opportunity to announce direct future actions. These included:

Building a national healthcare directory, starting with provider information. This is not an entirely new concept, as the first Trump administration spent considerable time and energy on a potential national directory.
Implementing a federated, modern identity verification solution for Medicare, with leaders pointing to Login.gov or CLEAR as examples.
Creating a digital insurance card allowing for real-time access to coverage information for Medicare beneficiaries and providers. Here, the administration is focusing on patient access through application program interfaces.
Taking CMS’s Data at the Point of Care from a pilot into general availability. The program enables providers to access Medicare claims data for their patients directly within their workflow.
Having the agency fully participate in the trusted data exchange to better respond to patient and provider requests and create a more interoperable and patient-centric system. Many stakeholders took this as continued support for the Trusted Exchange Framework and Common Agreement, although changes to the network are still on the table.

The timeline for these actions is up in the air, but the direction that CMS wants to go in seems rather clear at this point.

HIT Ecosystem RFI

In the RFI, CMS and ASTP provide some history of the legislative and regulatory actions around HIT. They state that although a policy framework exists for promoting interoperability and providing a pathway to exchanging data seamlessly, in the view of many stakeholders, that framework has not actually yielded results. Patients and providers still routinely have to fill out multiple forms and access numerous systems to access data – and they say that data exchange is anything but seamless and simple.

CMS and ASTP therefore ask a series of questions on how to achieve “large-scale adoption of health management and care navigation applications, reduce barriers to data access and exchange, realize the potential of recent innovations in healthcare that promote better health outcomes, and accelerate progress towards a patient-centric learning health system.” They request responses from:

Patients and caregivers.
Providers.
Payers.
Technology vendors, data providers, and networks.
Value-based care organizations.

Overall, CMS and ASTP seek feedback on “which elements of today’s digital health ecosystem are working, which are working inconsistently and need improvement, and which are impeding rapid progress.” The agencies also ask what future regs are needed to “to ease health data exchange and promote innovation in consumer digital health products, and how HHS can encourage patient, caregiver, and provider engagement with digital health products.”

Comments on the RFI were due June 16, 2025. While we are still going through some of the comments, major themes include the following:

Stakeholders largely supported the RFI’s major theme of empowering patients through technology.
Many pointed out the challenges of the current privacy framework under the Health Insurance Portability and Accountability Act, its gaps in covering certain types of HIT entities, and the need to certify health applications.
Value-based care entities asked for greater flexibility to pick and utilize the technology that works best for them to take on risk for patient populations or control total cost of care.
Many stakeholders noted the lack of clear direction on how information blocking enforcement will occur. They expressed concerns over the complex nature of the exceptions and a desire to simply understand the law to ensure it promotes data sharing.

RFIs and listening sessions typically signal the start of (potentially extensive) regulatory and policy efforts, and HHS could use the comments it received to develop more robust regulatory reforms. So, stay tuned for much more to come in the HIT space!

Until next week, this is Jeffrey (and Kristen) saying, enjoy reading regs with your eggs.

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Health Information Technology Policy Under the Trump Administration

Listening Session

HIT Ecosystem RFI

Authors

Jeffrey Davis

Kristen O’Brien

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