Trump’s executive orders have effects on health IT

Rebecca Vesely

About Rebecca Vesely

Rebecca Vesely is AHCJ's topic leader on health information technology and a freelance writer. She has written about health IT since the late 1990s for a variety of publications.

Donald J. Trump

Donald J. Trump

Health IT is getting tangled up in several of President Trump’s executive orders, and with more expected to touch the industry, tech companies and health IT divisions of health care providers will likely face continued uncertainty over staffing and regulations.

The immigration ban

Tech giants including Google, Apple, Amazon and Microsoft have been among the most vocal critics of Trump’s controversial (and possibly unlawful) immigration ban.

Leading health IT providers mostly have been silent. One notable exception is Jonathan Bush, CEO of EHR vendor athenahealth and cousin to former President George W. Bush and Jeb Bush. Jonathan Bush gave his characteristic unvarnished opinion via Twitter:

Several health IT associations I reached out to declined to comment on the immigration order.

Foreign worker visa programs

More actions coming down the pike could hit even closer to home for tech companies, report Peter Elstrom and Saritha Rai at Bloomberg. The Trump administration has drafted an executive order to overhaul the work visa programs for skilled workers. Trump had campaigned on an overhaul of the so-called H1-B visa program. Priority would be given to American workers, and the order would give visa priority to the most highly paid foreign workers, Bloomberg reported.

Indian outsourcing companies are among the largest employers of workers in the United States on H1-B visas. Those companies contract with IT departments of major corporations, and also some large health systems. The University of California San Francisco came under fire late last year for laying off about 97 tech workers and replacing them with offshore and H1-B workers through Indian outsourcing firm HCL.

Hospitals have long complained about a shortage of IT workers. One-third of healthcare managers said they had to postpone or scale back IT projects because of inadequate staffing, according to a 2014 Health Information Management Systems Society (HIMSS) survey. Changes to the visa program could put increased pressure on health systems to meet health IT goals and federal mandates.

‘One in, two out’ order

Speaking of mandates, another Trump executive order requiring government departments and agencies to remove at least two implemented regulations for every new one is getting attention from the health sector.

David Pittman at Politico’s ehealth reports that health IT stakeholders say the order could be a tough balancing act.

Because health care is one of the most regulated industries, the ramifications of the order could be huge, reports Adam Rubenfire at Modern Healthcare.

Some questions for reporters to ask their local and regional health systems:

  • Do they have any physicians or other staff members affected by the immigration ban?
  • Do they have any onsite workers with H1-B visas?
  • Do they contract with technology vendors that use the H1-B visa program?
  • What regulations from the HHS are the least and most important to them? Which ones would they like to see go as part of the “two out, one in“ executive order?

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