The federal government has a role in fostering scientific innovation in the United States. It’s in the law. Actually, it’s the product of several laws that created and then shaped the mission of a tiny agency with an unwieldy government name.
The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (usually referred to as more simply as ASTP) develops and oversees policies regarding data from the Department of Health and Human Services. ASTP is a small federal agency with an annual budget that averages about $60 million. With that budget, the agency coordinates the sharing of data across agencies within HHS as well as government agencies outside of the department. But to have greater impact, ASTP has to look to outside of government.
“We have to do it with industry,” Stephen Konya, chief, innovation and strategic partnerships for ASTP, said Tuesday, speaking during a presentation at the MedCity News INVEST Conference in Chicago.
The Office of the National Coordinator for Health Information Technology (ONC) was established by a 2004 executive order signed by President George W. Bush. As a part of the HHS, this office’s mission was to advance national goals for better and safer healthcare through an interoperable, nationwide health IT infrastructure, Konya said. This office worked across all HHS agencies and was also the primary coordinator to work with the White House on all health IT adoption and implementation.
The formation of this office followed the 9/11 terrorist attacks, which led to a need for data sharing across agencies, Konya said. In healthcare, this means not only coordinating information across federal agencies, but also across industry and the marketplace. In 2009, the federal Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law to promote adoption and meaningful use of information technology. The act also made ASTP/ONC into a formal federal agency. At that time, less than 10% of the information in healthcare was in a digital format, Konya said.
“The idea was how do we evolve getting the adoption of technology to healthcare as a multi-trillion dollar industry and use that as a way as to spur more economic activity and growth,” Konya said.
Beyond moving healthcare data into digital formats, the office aimed to make it interoperable so it could be used to drive down costs, create better outcomes for patients and more efficiencies for industry stakeholders. By 2016, 80% of healthcare information was digital. Still, there were state and regional differences. Closing those gaps was one of the goals of the 21st Century Cures Act. Signed into law in 2016, the wide-ranging law’s digital components included the promotion of sharing of electronic health information. Today the amount of healthcare information that’s officially in a digital format is more than 90%, Konya said.
ASTP’s coordination within the government now spans about 40 federal agencies outside of HHS. Within HHS, the office coordinates with about 20 or so agencies within the department (though Konya said that number will be cut in half with the reorganization underway). Externally, outside of the federal government, ASTP focuses on integrating with public health and human services on data issues. As an example, Konya pointed to the Covid-19 pandemic during which ASTP coordinated information on testing status and disease spread.
Fostering a more effective marketplace and greater competition are among the ASTP duties spelled out under the HITECH Act, Konya said. While the agency has no regulatory authority, it can coordinate and support access to government data. For example, ASTP can facilitate access to Centers for Medicare and Medicaid data in order to help industry better understand payment models and their effectiveness, Konya said.
Additional federal law plays further expanded ASTP’s mission. The America COMPETES Act, signed into law in 2007, was intended to increase investment in scientific research to promote U.S. competitiveness. Konya said that in the first Trump administration, ASTP launched a platform under this act that enabled the agency to participate in public-private partnerships. These partnerships are known as “InnovationX.” One of them, KidneyX, promote innovation in kidney treatment. Other InnovationX partnerships that followed include PandemicX and CancerX.
ASTP also partners with the innovation community, spanning startups, investors, incubators, and more. In his role at the agency, Konya said his constituency includes early adopters implementing technologies as well as entrepreneurs and developers. It’s also investors.
“You understand where your portfolios are failing and the headwinds that they’re facing,” Konya said of investors. “And you’re asking them to hit certain benchmarks and you know what the problems are. So we have to engage you to understand and learn that so you can make the most efficient deployment of your capital.”
Photo: Nick Fanion, MedCity News