Sound control can revert to social media rules, again: Rucker

The Trump administration may shift deadlines for healthcare companies to meet information blocking and interoperability regulations for a second time as suppliers remain under stress from COVID-19.

“We have made some changes to the timing of our rule and accompanying CMS rule and are closely monitoring the situation for further adjustments,” Don Rucker, head of the National IT Health Coordinator’s office, said at the meeting. CB Insight.”All I’m saying right now is that we’re aware of the COVID infection and looking at the necessary changes.”

HHS submitted an interim final decision to the Office of Management and Budget titled Information Blocking and ONC Health IT Certification Program: Extending Compliance Date and Deadlines in Response to COVID-19 Public Health Emergency, which occurred in January. September was received.

The ONC declined to comment on the rule. However, the title implies that it will include the dates set in the full information blocking provisions – specifically, the emerging November deadline for supplier compliance – and the dates of the terms and conditions and maintenance of the certification provisions under which EHR platforms must be interoperable.

The two rules intended to end the health information blockade were finalized by the Trump administration in March before the United States was hit by the coronavirus pandemic. Due to the growing burden of COVID-19 on the healthcare system, HHS postponed deadlines to comply with regulations about a month later.

However, the closest deadline, November, is only a little over a month away, so suppliers will have to request another deadline.

As things stand, providers must be able to share certain types of medical information with other providers and their patients by November 2, otherwise, sanctions for information blocking must be imposed. EHR vendors also need to be able to integrate with third-party applications via standardized application programming interfaces.

Providers are required to share Admission, Discharge, and Referral (ADT) notices (ADTs) to track patient movements by spring 2021. Other requirements mandating participation in federal programs to provide patients with electronic access free to their personal health data and to create supplier directories Availability for current and potential participants will not be available until spring 2021.

Providers applauded the rejections and said the measures would free up time and resources to prepare for a pandemic, although the American Hospital Association believed the government could have been even more lenient.

This was at a time when there were only about 825,000 confirmed COVID-19 cases and about 45,000 deaths nationwide, most concentrated in early hot spots like New York City. Since then, amid a largely non-existent federal response, the pandemic has grown into a virulent monster with no signs of slowing down. To date, there are nearly 7.1 million confirmed cases and 205,000 deaths, according to the Johns Hopkins University Coronavirus Control Panel. The United States averages more than 43,000 new cases per day, 16% more than a week ago.

This may increase the pressure on the ONC and the CMS to extend the acceptance period for the two information blocking policies. In a June letter to the CMS, the AHA asked the government to reconsider incorporating some of the required regulatory frameworks, including the ADT standard, a side-by-side solution, indicating that sharing COVID-19 funds would make it hard to obey.

But health informatics experts have generally spoken out against the delays. COVID-19 has exposed systemic weaknesses in healthcare, including the inability of hospitals and healthcare systems to quickly share data with each other and with public health agencies.

This has prevented the government and private sector partners from getting a complete overview of the pandemic, including confirmed cases, diagnostic test results, treatment results, etc., complicating efforts to allocate resources, contact tracing, or other public health responses.

The administration faced fierce industry opposition to rule-making, especially from IT vendors who feared that opening up data silos could threaten their business models. Critics have engaged in lobbying activities, warning of privacy concerns that arise from providing third-party companies with access to medical records and recovery of protected health information under the umbrella of HIPAA privacy law.

Giant EHR Epic has even threatened to sue HHS over the upcoming regulations, though the general fury subsided after they were finalized.

“We’ve been under pressure here all the time,” Rucker said. “Whenever DC’s powerful economies are disrupted, the city’s activities put them under pressure.

Moving forward, however, Rucker hopes the rules will drive a new healthcare app economy, promote more digital healthcare business models, and simplify existing ones like Telehealth.

He thinks about all the experience that surrounds you. How does the nurse get my history information over the phone or video, or do I have to re-enter it? How do I get my drug list? Prescriptions, lab prescriptions, diagnostic tests, how are they sorted? How is the follow-up coordinated?   

The ONC official also hopes that major consumer brands such as Apple and Google will be more involved when patients contact well-known agencies to obtain information about their data.

In addition to the regulations that are driving the industry toward interoperability, it’s also important for companies to try to find ways to make patient health data relevant and applicable to them, experts say. Some hope this may be a good aspect of the pandemic: increased consumer demand for health awareness and control.

“I am totally in favor of the push. But there is also an attraction, and I think we haven’t realized it yet,” said Karen DeSalvo, a former ONC official during Barack Obama’s presidency and currently head of health by Google on CB Insights.