The U.S. Department of Health and Human Services (HHS) has proposed new rules that would make it easier for patients and providers to securely access, use and exchange electronic health information (EHI). The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued the rules with the goal of stimulating competition and innovations that would give patients more choices and easier, cost-free access to and control over their own health information.
CMS issued a proposal of changes in healthcare delivery that are aligned with the MyHealthEData initiative which supports a seamless flow of EHI without causing burden on patients and providers. By making a variety of health data more readily available CMS suggests that researchers and innovators are likely to develop new technologies.
Last year, CMS finalized regulations that impose potential payment penalties on hospitals and clinicians that do not make EHI access easier for their patients. Now CMS is proposing requirements that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges must give members immediate electronic access to medical claims and other RHI by 2020.
CMS also proposes that healthcare providers and plans adopt open data sharing technologies that would make enable patients and providers to access EHI as patients move to and from different plans and facilities. “By ensuring patients have easy access to their information, and that information follows them on their healthcare journey, we can reduce burden, and eliminate redundant procedures and testing thus giving clinicians the time to focus on improving care coordination and, ultimately, health outcomes,” stated HHS.
In addition, CMS has suggested a rule that would eliminate “information blocking” by reporting healthcare providers that engage in the practice. Information blocking happens when hospitals and other providers make it difficult to freely access EHI which places barriers on efforts to improve interoperability. By publicly reporting providers who engage in the practice, CMS hopes to discourage others from doing the same.
The American Hospital Association (AHA) supports many of the efforts being made to improve information sharing and interoperability but also felt CMS went too far in parts of its proposal, particularly a portion of the rule that addresses information blocking by holding providers accountable and vulnerable to potential penalties. “We cannot support including electronic event notification as a condition of participation for Medicare and Medicaid,” said Ashley Thompson, AHA Senior Vice President for Public Policy Analysis and Development in a statement. “We believe that CMS already has better levers to ensure the exchange of appropriate health information for patients. We recommend the agency focus on building this exchange infrastructure rather than layering additional requirements on hospitals.”
Meanwhile, ONC wants the healthcare industry to adopt standardized application programming interfaces (APIs), which would give people the ability to use their smartphones and other mobile devices to access structured and unstructured EHI formats easily, securely, and at no cost. The proposed rule also supports the information blocking provisions of the 21st Century Cures Act, including identifying reasonable and necessary activities that do not constitute information blocking. The proposed rule also asks for comments on pricing information that could be included in their EHI which would enable people to see how much their healthcare is costing them.
American Health Information Management Association CEO Wylecia Wiggs Harris, PhD, CAE, said while her organization was still reviewing the new proposals closely (at press time) some parts of the rule appear favorable to AHIMA’s mission. “At first glance, we are pleased that ONC’s information blocking rule acknowledges in its exceptions the importance of promoting the privacy and security of electronic health information, which is a core tenet of the HIM profession,” Wiggs Harris said in a statement. “Additionally, we are pleased that CMS’s proposed rule includes a request for information on leveraging CMS’s authority to improve patient identification. Accurately identifying patients and matching them to their data is essential to coordination of care and a requirement for health system transformation, as well as the continuation of our substantial progress toward nationwide interoperability.”
CMS is accepting comments on the major provisions in the proposed rule until early April; it can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection.
To view the ONC rule, visit https://www.healthit.gov/topic/laws-regulation-and-policy/notice-proposed-rulemaking-improve-interoperability-health
