New Proposed Rules Pave the Way for Healthcare Interoperability

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Interoperability is more than a buzzword in healthcare; it’s a foundational principle that can deliver the seamless and secure sharing of information, leading to better patient outcomes. But interoperability isn’t an easy feat to accomplish.

However, earlier this year, the Department of Health and Human Services (HHS) proposed new rules aimed at supporting the consistent access, exchange, and use of electronic health information (EHI), making positive steps forward to achieving true interoperability throughout the nation’s healthcare landscape. With the deadline for several of the requirements looming near, the proposed rules are helping to guide interoperability between health systems and in EHR innovation.

Points of the New Rules

HHS’ proposal, in concert with the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), focuses on providing patients electronic access to their medical data at no cost. Designed to increase competition and foster innovation that promotes patient access and control over their health information, the rules call on the healthcare industry to adopt:

• New tools that enable patients more choice in care and treatment
• Standardized application programming interfaces (APIs) that allow patients safe and easy access to structured EHI via smartphones or other mobile devices

The rules also implement the blocking provisions of the Cures Act and propose seven exceptions to the definition of information blocking, including identifying reasonable and necessary activities that don’t constitute information blocking. To incentivize providers and clinicians to refrain from such practices, the CMS rule proposes to publicly report those that unreasonably limit the availability, disclosure, and use of electronic health information, thereby undermining efforts to improve interoperability. Further, the proposal also asks for publicized pricing information, allowing consumers to shop for and coordinate their own healthcare.

CMS Administrator Seema Verma said that the new rules build “on CMS’ efforts to create a more interoperable healthcare system, which improves patient access, seamless data exchange, and enhanced care coordination.”

Taking Steps Forward in Interoperability

HHS Secretary Azar stated that the 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.”

Increasing the seamless flow of health information, the proposed changes also align with the MyHealthEData initiative and reduce the burden on patients and providers while unpacking data for researchers and innovators. Fully supporting the patient-centered healthcare model, the proposed rules require providers (including Medicaid-, Children’s Health Insurance Program-, Medicare Advantage Plan- and Qualified Health Plan-providers in the Federally-facilitated Exchanges) to provide enrollees with immediate electronic access to medical claims and other health information electronically by January 1, 2020, thus enabling over 125 million patients the ability to retrieve their data. Further, CMS would also require these providers and plans to implement open data sharing technologies to support transitions of care as patients move between plan types, providing patients with easy access to their information while ensuring their information follows them through their healthcare journey. 

Information is power, and with true interoperability, patient outcomes can be greatly improved. “These steps forward for health IT are essential to building a healthcare system that pays for value rather than procedures, especially through empowering patients as consumers,” says Secretary Azar.

New Rules Provide a Foundation for the Future of Interoperability

Researchers in a recent Deloitte survey commented, “Today, the US health care system is a collection of disconnected components (health plans, hospital systems, pharmaceutical companies, medical device manufacturers, etc.).”

Targeted at eradicating these siloed elements, the draft rules call for organizations to meet many of the requirements as early as the first of the new year. Polling leaders in large health plans and systems to gauge their attitudes and priorities around the proposed rules, the Deloitte survey revealed that most are:

• Seeking to use the proposed initiatives to advance their interoperability strategies
• Planning to go beyond the rules’ guidelines and are already building APIs for interoperability

However, U.S. healthcare digital maturity still dawdles behind, with adoption of business technologies that would help with customer engagement lagging other industries by about a decade. Healthcare transformation is inevitable, and those that don’t make interoperability a priority run the risk of being non-compliant and losing patients. Paving a successful roadmap for the future of interoperability will require a genuine buy-in by healthcare providers and systems, rapid alignment to the proposed requirements, and a clear strategy for their digital maturity.

Deloitte analysts remarked, “Organizations that fail to see beyond compliance deadlines and realize the broader value of interoperability could risk falling behind. Organizations that develop and implement a strategic approach to interoperability are likely to have a competitive advantage with insights, affordability, and consumer engagement in the future of health.”

As both an EHR pioneer and leader, ChartLogic understands the importance of interoperability and why it’s critical for the future of healthcare. Facilitating both your digital transformation and maturity, we deliver comprehensive technology solutions purposely built for the healthcare sector, enhancing patient care while streamlining workflows, creating efficiencies, and reducing costs. Stay up to date on all things related to healthcare technology by subscribing to our blog.