Despite delays to push back new federal data-sharing requirements, providers and payers say they are still struggling to meet the compliance deadlines while addressing the COVID-19 pandemic.
About 80% of providers report that the pandemic has impacted their readiness to comply with new interoperability and patient access rules from the Department of Health and Human Services (HHS), according to a survey of providers.
The survey from the eHealth Initiative (eHI) was based on responses from 189 organizations, including payers, physician practices, hospitals, and vendors, found that the COVID-19 pandemic is hampering organizations' readiness.
On March 9, the HHS issued two widely anticipated rules, one each by the Office of the National Coordinator for Health IT and the Centers for Medicare and Medicaid Services (CMS) that promote patient access to data and improved information sharing. The rules implement interoperability provisions of the bipartisan 21st Century Cures Act.
HHS has twice pushed back the compliance timelines for the healthcare information blocking and interoperability regulations due to the pandemic.
The information blocking requirements were set to take effect Nov. 2. Under a recent interim rule, providers won't be required to come into compliance until April 5, 2021. Compliance for conditions and maintenance of certification requirements related to application programming interfaces (APIs) will also go into effect in April 2021.
New standardized API functionality won't be required until December 2022.
The survey was conducted from August to September, before the Trump administration issued an interim final rule extending the compliance deadlines. At the time, less than half (47%) of organizations said they were "somewhat prepared" to meet the current requirement deadlines, the survey found.
“Despite the recent delays that push back the applicability date of many of the requirements in the final rules, the results reveal that payers, providers, and vendors have several areas of concern related to readiness,” said Jen Covich Bordenick, eHI chief executive officer in a statement.
While providers have been most significantly impacted by the current pandemic, all stakeholder groups remained concerned about the capability to implement and maintain patient access APIs, Bordenick said.
As part of the rule, ONC is calling on the industry to adopt standardized APIs, specifically Fast Healthcare Interoperability Resources (FHIR), to help allow individuals to securely and easily access structured electronic health information using smartphone applications.
Specifically, providers were concerned about managing multiple APIs connected to different systems while payers cited transforming data into a readable and digestible format as a major challenge.
Across the board, industry stakeholders say there are too many internal competing priorities and the ONC and CMS rules are not at the top of organizations' "to-do" list. Forty-four percent of respondents cited lack of prioritization as the biggest issue impacting readiness, 41% said there wasn't enough time for implementation and 40% cited the ongoing focus on the COVID-19 pandemic.
Among providers, only about two-thirds (67%) said they were familiar with the patient access and interoperability rules, putting them behind payers (100% familiar with the rules) and vendors (92%).
Payers and providers also reported major technology hurdles that could impede their efforts to get into compliance. The biggest data challenges to overcome are lack of data standardization (47%), lack of technical interoperability (44%), and shared data quality (44%), according to the survey.
Only 18% of providers report having expertise in FHIR-based healthcare data exchange models while 74% of vendors report having expertise in that area and 36% of payers.
Vendors and payers also report moving further ahead on HL7 FHIR initiatives. When it comes to interoperability initiatives, providers cited secure messaging and direct messaging as their top initiatives, to date.
The majority of payers (79%) and providers (69%) said they would consider using vendor solutions and staff to help meet the required deadlines.