Members of our leadership team recently attended The Assistant Secretary for Technology Policy Annual Meeting in Washington, DC. Held from December 4-7, the meeting convened health IT leaders and stakeholders from across the country for two days of speakers, breakouts and educational sessions on the intersection of health care, public health, policymaking, and technology.

We asked our team to summarize their key takeaways from the meeting, including their favorite sessions and most memorable moments. Each of them shared their unique perspective on the event:

 

Scott Stuewe, President and Chief Executive Officer

While presentations at the ASTP/ONC annual meeting are always of great interest to attendees, sometimes the most impactful insights come from the informal interactions at the event where nearly all of our colleagues have an opportunity to discuss the state of the interoperability union. Many of the presentations and panels at this year’s event reflected on the success in implementing the provisions of the 21st century Cures Act including TEFCA.

One panel I attended titled A Decade of Data Examined: The Evolution of Health IT in the United States reviewed the progress made since the HITECH act stimulus and the certification rule moved health IT adoption from single digit percentages to near ubiquity. The panel took stock of how the nation moved from paper charts to electronic ones and how hospitals are reporting that for the four tracked interoperability domains – send, receive, find and integrate – 70% of hospitals say they engage in all four domains, and importantly, for those domains, the share of hospitals who say they “routinely” do these activities has increased to 84%, 73%, 76% for send, receive, and find respectively. This demonstrates that the incentives and the national networks, including the DirectTrust network – have had an enormous impact on adoption since 2018. Of note, the percentage of hospitals that report that they routinely integrate data received is stuck at about 51% suggesting workflows for incorporation of data received have not kept pace with the movement of data. The panel also covered the rapid rise of Electronic Case Reporting and other public health reporting as well as the near ubiquitous use of electronic prescribing in the market place. Over the last decade, irrespective of which party was in power, the real experience of interoperable exchange has improved steadily, and you can see it in the data.

Despite steady past performance improvements, outside of the formal presentations, much of the conversation in the lobbies and hallways revolved around the potential impact of a change in the administration. Discussions about which rules finalized within the look-back window of the Congressional Review Act (CRA) would possibly be reversed by the incoming congress under a unified government dominated these discussions. Of particular interest is the thousand page HTI-2 rule which we are hearing may only be finalized in part focusing on the elements which would likely be subject to reversals under the CRA, leaving the majority of the content to be finalized under the new administration. Whatever is contained in the rule which is now being reviewed at the Office of Management and Budget (OMB) we are hearing that it should hit the federal register before year’s end, perhaps before the holiday. Informal polling suggests that while there will no doubt be an impact to a new administration, interoperability and the privacy and security of health data have remained a constant priority regardless of the party in power.

Kelly Gwynn, Chief Operating Officer

One of my key takeaways from the ASTP/ONC Annual Meeting was the exploration of artificial intelligence (AI) as both a tool to empower patients and a frontier requiring careful navigation. A highlight was the session Empowering Patients: Enhancing Patient Access and Navigation in Cancer Care, where patient advocates shared how AI is enabling them to provide more efficient, personalized support. From streamlining care coordination to enhancing access to vital information, AI is proving to be a powerful ally for both patients and their families.

However, discussions during the panel “What in the GPT? Does Generative AI Have a Place in Health Care Delivery?” reminded us that while the potential of AI is immense, significant challenges remain. There was a clear message that we must proceed with caution, particularly in addressing known biases in AI models and recognizing the regulatory gaps in this rapidly evolving field. Moreover, the disparity in healthcare technology adoption—such as small rural organizations still struggling with basic EHR implementation—underscores the importance of equitable progress. Moving too quickly without proper oversight could exacerbate these disparities rather than close them.

The meeting struck a thoughtful balance between optimism for what AI can achieve and the critical need for deliberate, responsible implementation. It’s this measured approach that will ensure AI’s benefits are felt broadly, without leaving vulnerable communities behind.

Kathryn Ayers Wickenhauser, Chief Strategy Officer

If I had to sum up the “vibe” of the ASTP Annual Meeting (from the presentations to the halls), in three words, they would be progress, uncertainty, and enthusiasm.

First, Micky Tripathi has been a significant and impactful National Coordinator (and now Assistant Secretary for Technology and Policy and Acting Chief AI Officer for HHS). His leadership has helped ONC, and now ASTP, significantly advance interoperability of health technology to a future state, which he described as the interactivity of health information. The standing ovation for him and his service brought many in the room, including myself to tears. While there is uncertainty about what a change in administration may mean, earlier he shared a picture of many of the former National Coordinators together laughing, highlighting how investment in health technology infrastructure has long been a bipartisan effort and camaraderie.

Just like Scott, one of my favorite sessions highlighted “a decade of data” from the ONC, and showed quite literally the progress of health technology and information exchange. I appreciated ASTP team members highlighting how far we have come, and still, many continued opportunities for the future. Since I was “on the ground” and helping clinicians with Meaningful Use, it was striking to think back to 2014 when Meaningful Use Stage 2 was deployed (and even before that with MU Stage 1), and see the tangible impact of the efforts to implement health technology have had, including as Scott highlighted, the proliferation of Direct Secure Messaging.

However, the Tracking Impact: Family Medicine Physicians Experience with Interoperability session painted a different picture when juxtaposed with the decade of data. As Alex Mugge from CMS said multiple times, “we have the technology; the tech is here”, yet results from a survey conducted by the American Board of Family Practice in conjunction with recertifying boarded family medicine physicians illustrates while the tech may be here to help with interoperability and sharing of information, clinicians either don’t know how to use it, it isn’t easy to use, or it’s not working how we intended. This is a huge gap: there’s an industry perception that most of the heavy-lifting is done, yet clinician experience, and even our own experience we can point to as patients, illustrate there is a long way to go. Personally, I thought this session did a wonderful job highlighting the dichotomy between these two realities. Furthermore, the panelists also did a tremendous job threading the needle between how technology can help decrease clinician burnout. Ultimately, there is a real issue here that health technology needs to address – how do we educate clinical settings and patients about ways to leverage health technology updates to decrease the cost of care, increase care quality, improve outcomes, and reduce burden?

Overall, it did feel like there was an air of enthusiasm and collaboration. To me, it seems we are at the precipice of a new era of health technology and interoperability, especially with other advancements like AI. It is clear that this next phase will double-down on how to instantiate technical trust in an ever-connected world, a place where DirectTrust has a lot of expertise. I look forward to the continued collaboration with the members of DirectTrust, our peer organizations, and the greater health technology in this new wave of adopting, implementing, and most importantly, using health technology.

Susan Clark, Senior Director of Community and Advocacy

There was no mistaking the star of the show at ASTP was TEFCA. A large portion of the event was dedicated to how far it’s come, and the enormous potential into the future. Though the numbers of transactions are high, the penetration to the broader ecosystem is low. TEFCA enthusiasts push onward to expand the reach and demonstrate value while others are standing by to see where their roles may be within TEFCA while providing other valuable interoperability services that are not (yet) served by TEFCA.

The Meeting marked an emotional farewell to the Assistant Secretary for Technology Policy and National Coordinator, Micky Tripathi. His energy, authenticity, and initiative makes everyone around him want to do more. May we not lose the trajectory he set forth. I believe the progress that was made over his tenure is evidenced by the enthusiasm for the breadth of expansion of interoperability into areas beyond hospitals and physician offices. This could not be a conversation we would be having if we lacked trust in the success that came before it.

Examples of this include:

  • USCDI+: Advancing data standards and mobility within sub-sectors such as cancer care and behavioral health.
  • Human services interoperability : The session I went to on this was standing room only, demonstrating the desire for this integration. I love the cross-agency partnerships, such as with Administration for Children and Families.
  • Public health: This topic was front and center throughout the event. We’ve moved beyond the crisis mode of the pandemic into thoughtful advancements to bolster the infrastructure. It seemed like there were representatives from the CDC or APHL everywhere I turned.
  • Pharmacy interoperability: Capturing medication information has been essential since the dawn of Meaningful Use but the pharmacy and the pharmacists are finally being recognized as a critical appendage of the care teams.
  • Patients: The individuals at the center of why we sought interoperability in the first place have finally been given a seat at the big kids table to have their needs for accessing and sharing information heard.