iPatientCare Blog - 21st Century Cure Act Impact Of Information Blocking Rule on Interoperability Gaps
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21st Century Cure Act: Impact Of Information Blocking Rule on Interoperability Gaps

Interoperability gaps are everywhere in healthcare. It is a persistent challenge in the US healthcare system; the ability to send and receive patient health records to and from different hospitals, health systems and other venues of care is the biggest challenge in the industry.

Earlier this year, two offices of the US Department of Health and Human Services (HHS) – the Centers for Medicare and Medicaid (CMS) and the Office of the National Coordinator for Health IT (ONC) aimed at promoting Health Data Exchange through Information Blocking Rule & the Interoperability Rule (collectively referred to as the Proposed Rules).

Goal For Information Blocking Rule

The proposed separate but related rules place a strong focus on improving the ability of health care providers to transmit patient health information to each other (patients and clinicians) in an interoperable format. This advancement of rules aimed to support seamless and secure access, exchange, and use of electronic health information (EHI) be made available at no cost, and which could go into effect in 2020.

“These proposed rules strive to bring the nation’s healthcare system one step closer to a point where patients and clinicians have the access they need to all of a patient’s health information, helping them in making better choices about care and treatment,” said HHS Secretary Alex Azar.

An Overview of the Proposed Rules – Information Sharing and Interoperability

CMS Proposed Rule –

  • The proposed rule from CMS enables the healthcare delivery system to support the MyHealthEData initiative and would help increase the seamless sharing of healthcare data, reduce the burden on patients, providers, researchers, and innovators.
  • CMS finalized regulations requirements will only be imposed on hospitals and health care providers that are having an electronic health record (EHR).
  • CMS would also require these health care providers and plans to implement open data sharing technologies to support transitions of care.
  • CMS proposes a patient’s easy access to their information, and that information follows them on their healthcare journey. The smooth transition of care can reduce burden, and eliminate redundant procedures and testing thus giving clinicians the time to focus on improving care coordination and, ultimately, health outcomes.
  • The CMS rule also proposes to publicly report providers or hospitals that participate in “information blocking,” Making this information publicly available may incentivize providers and clinicians to refrain from such practices.

ONC Proposed Rule –

  • ONC’s proposed rule helps ensure that patients can electronically access their electronic health information at no cost. It will provide secure and more immediate access to health information for patients and their healthcare providers.
  • The ONC Proposed Rule announces the information blocking provisions of the 21st Century Cures Act and listed seven “reasonable and necessary activities” that do not constitute information blocking. Seven “Allowed” Activities (Proposed) identified in the ONC Notice of proposed rulemaking (NPRM) where sharing information can be withheld, or fees charged that would not be considered information blocking:
  • Preventing harm to patients or other individuals
  • Promoting privacy
  • Promoting security
  • Recovering costs reasonably incurred to make the API technology available
  • Infeasible requests for data
  • License conditions that the data discloser or API technology supplier imposes on the app developer and which are reasonable and non-discriminatory.
  • The proposed rule asks the healthcare industry to adopt new tools allowing more choice in care treatment, such as Application Programming Interfaces (APIs), to help allow individuals to securely and easily access structured electronic health information (EHI) using smartphone applications.
  • The proposal empowers the HHS Office of Inspector General to investigate claims of information blocking and to issue civil monetary penalties up to $1,000,000 per violation.
  • Policies in the proposed CMS and ONC rules align to advance interoperability in several important ways. Together, these proposed rules address both technical and healthcare industry factors that become a hurdle to the interoperability of healthcare information and limit a patient’s ability to access essential health-related data.

Challenges to Healthcare Interoperability, according to ONC

  • Technical – Lack of interoperability access in current EHR
  • Financial – Costs of developing, implementing and optimizing health IT.
  • Trust – Leakage of information
  • Administrative Requirements – Continuously changing Federal documentation and administrative requirements.
  • Reporting Requirements – Federal reporting requirements

The Consequences Of Implementing Information Sharing And Interoperability Rule On Healthcare Providers and Hospitals.

  • Is it a good option? – Let’s start with what we can all agree on – For better patient care and patient’s right to access their medical data, the goal of seamless information sharing and interoperability is a noble one. Prioritizing interoperability gaps is incredibly important as this will help set healthcare organizations. It will also effectively navigate and manage any interoperability challenges they encounter, but we must also consider disparities across healthcare organizations when it comes to adopting interoperability capability.
  • Is it a bad option? – Potentially, not everyone will address the mandates of the rule at the same pace. The awareness and understanding of the rules are relatively low. Wealthier organizations or healthcare providers will be strategically able to meet the requirements of the rule more quickly, thanks to their financial resources but at the same time, rural or less financially stable organizations will stay behind in the race, which could ultimately widen the gaps of interoperability. To stay ahead of these regulations, every organization will need to shift their perception of the mandates and seek innovative approaches to build out and achieve interoperability as a strategic asset.

Scope Of Need To Think More Strategically

  • Regardless of when the proposed rules ultimately come to existence, there is strong momentum to improve patient care and lower costs through a more transparent system.
  • Today’s interoperability challenges will only be compounded by tomorrow’s, so we hope this rule motivates organizations to think more strategically about how they address and pursue data integration and management.
  • Data will be fully transparent and exchanged via a trusted network through interoperability, there is a crucial need for payers to ensure the data is accurate, clean and actionable. Healthcare organizations and providers will have to have scope for investment in modernizing their technology and systems architecture, including adopting master data management strategies, to enable interoperability (keeping proposed rules in mind). we urge organizations to zoom out and look at things from a more strategic and long-term perspective.

Look Froward For Compatible HealthCare IT

As we know the consequences are like both sides of the coin, so the best thing healthcare providers can do now is to assess their EHR’s capability and plans. The government is looking ahead to turn the page as soon as 2019 ends, so the providers don’t have to sit back and wait till Information Sharing And Interoperability Rule comes to existence. They must talk to their EHR vendor and tell them about their requirements for the ability to get access to the data because vendors won’t move forward without the demand from their customers. If the EHR vendor is not planning on adding interoperability access, it may be time to look for another one to avoid being left behind. iPatientCare can be your trusted vendor for all your demands. It gives you the real power of EHR interoperability by facilitating standards-based data exchange with other EHR systems, health information exchanges (HIEs), labs, pharmacies, payers, immunization and disease registries, and public health agencies. All these exchanges between healthcare information systems happen accurately and securely within the existing work-flow.

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