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February 15, 2019

HHS Releases Proposals Seeking End to Information Blocking, Promoting EHR Interoperability

Allison Inserro
HHS released 2 long-awaited rules meant to transform how health records and medical claims are delivered and communicated, with one aimed at aggregating electronic health records and claims information into an interoperable mobile format that patients could call up on their devices and another that would require that access to electronic health information come at no cost to the patient and end information blocking.
HHS released 2 long-awaited rules meant to transform how health records and medical claims are delivered and communicated, with one aimed at aggregating electronic health records and claims information into an interoperable mobile format that patients could call up on their devices and another that would require that access to electronic health information come at no cost to the patient and end information blocking.

HHS said the changes, which would take effect in 2020 for those enrolled in Medicare, Medicaid, or the Children’s Health Insurance Program or who have insurance through the exchanges, will increase choice and competition.

The CMS rule is similiar to its Blue Button 2.0 initiative, which uses an open application program interface, more commonly referred to as an API, to give private tech developers access to data in a form that can be built into their apps so that patients could have information at their fingertips at any provider visit.

The CMS rule also proposes to publicly name providers or hospitals that participate in information blocking, or practices that limit the sharing of electronic health information; CMS said this could lead to practices to refrain from limits.

CMS said provider burden would be reduced, and it would also “eliminate redundant procedures and testing, thus giving clinicians the time to focus on improving care coordination and, ultimately, health outcomes.”

“We cannot build a value-based healthcare system without value-based information technology,” said Eric D. Hargan, HHS deputy secretary.

For instance, hospitals would be required to send an electronic notice to a provider when a patient was discharged. That would help improve care coordination, CMS Administrator Seema Verma said. It could also help improve care for dual-eligible patients, she said.

On the other hand, the rule would not require a hospital to notify a provider that the patient is in the emergency department, or has been admitted, which were 2 of the suggestions made by the National Association of Accountable Care Organizations in a letter sent to CMS last year.

But Verma said organizations could go above and beyond what the rule says. She also said patients could decide to share their data with researchers.

CMS said the change would affect 125 million patients, and possibly more if insurers implement the same system for commercial clients.

The rule from Office of the National Coordinator for Health Information Technology details prohibitions against information blocking, which was included in the 21st Century Cures Act, including identifying “reasonable and necessary activities” that should not be considered information blocking. Thus far, the rule spells out 7 actions that would not be considered information blocking: and would be excepted from any penalties: preventing harm; promoting privacy; promoting security; recovering costs “reasonably” incurred to provide access, exchange, or use of information; responding to requests that are not feasible; licensing of interoperability elements on reasonable and nondiscriminatory terms; and maintaining and improving health information technology.

It calls for the adoption of a standardized API and says patients can electronically access their electronic health information at no cost. Third-party app developers using the information can set their own price, Verma said.

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