- Healthcare Interoperability Mess Created by Vendors’ Proprietary IT
- Data Proliferation Fuels Need for Healthcare Interoperability
Rucker stressed that information blocking practices limited the availability and use of EHI for authorized and permitted purposes, which discouraged public and private sector investment in health IT infrastructure. He thanked Congress for restricting information blocking in the 21st Century Cures Act.
Other exceptions to the information blocking ban proposed by ONC include certain activities that are reasonable and necessary to prevent harm to patients and others and to promote the privacy and security of PHI.
In addition, ONC is proposing to permit the recovery of certain types of reasonable costs incurred to provide technology and services that enable access to EHI and facilitate the exchange and use of EHI. It also proposes to permit an entity to decline infeasible requests to exchange EHI but would require the actor to find a reasonable alternative for providing EHI.
Kate Goodrich, MD, chief medical officer and director of the Center for Clinical Standards and Quality at the Centers for Medicare and Medicaid Services, said that her agency has proposed a rule on interoperability and patient access designed “to move the health care market toward interoperability.”
CMS is proposing to require payers subject to the proposed rule to share health claims and other information electronically with their enrollees by 2020.
The CMS proposed rule also facilitates data exchange for healthcare providers and suppliers, including doctors and hospitals, by encouraging access to health information about their patients, regardless of where the patient may have received care previously, Goodrich related in her prepared testimony.
Alexander Tells Regulators to Slow Down
The chairman of the Senate committee was less concerned about the substance of the interoperability proposals and more about their timing.
Sen. Lamar Alexander (R-TN) expressed concern about the January 1, 2020, deadline for insurers to begin sharing data with patients at no cost to the patients. “The administration should not move too far, too fast on implementing new rules on electronic health information,” he said in his opening statement.
“The best way to get to where you want to go is not by going too far, too fast,” Alexander said. “I am especially interested in getting where we want to go with input from doctors, hospitals, vendors, and insurers, so we have less confusion, make the fewest possible mistakes and make sure we don’t set some kind of unrealistic timeline,” he observed.
Lamar thanked ONC and CMS for extending the comment period deadline on the proposed rules from May 3 to June 3.
Alexander referred to an earlier hearing in which industry representatives complained about the timelines. Mary Grealy, president of the Healthcare Leadership Council, cautioned at the hearing that providers and other stakeholders are facing a complex task in trying to make EHI available to patients.
At the March hearing, Christopher Rehm, chief medical informatics officer at Lifepoint Health, placed the blame for the interoperability problems squarely on the shoulders of the vendors. Vendors are developing and selling proprietary IT products and services that do not interoperate, he said.
“We need our health care technology and software systems to work in real life settings and in concert with many other vendor technologies if we expect them to meet the needs of patients and providers now and in the future,” he testified.
“It is the provider organizations who have been left to bridge the gap with everything from integration and interface engines, to workarounds that lead to significant ‘clicks’ for clinicians, to even a combination of electronic and manual processes,” he added.
