The deadline for major stakeholders in the healthcare system to ensure interoperability of computer systems fast approaches: In fact, the deadline is tomorrow.
Interoperability allows a free flow of medical information between providers. Too often, for example, a primary care physician cannot access information about their patient that’s kept in the computer system of the nearby hospital and vice versa.
COVID-19 underscored the knowledge gaps a lack of such interoperability can create. Legislators said enough is enough and included stipulations about interoperability in the 21st Century Cures Act. The Cures Act Final Rule (PDF) promises to “make sure health information follows a patient by preventing industrywide information blocking practices and other anti-competitive behavior by those entrusted to hold patients’ electronic health information.”
The Cures Act empowers the Department of Health and Human Services (HHS) to levy fines against institutions and facilities that block the free flow of patient information among providers.
Major provider organizations last week sent a letter to HHS Secretary Xavier Becerra that, in essence, says that they can live with the Oct. 6 deadline—so long as it’s Oct. 6, 2023.
“Based upon feedback from our members that continues to build, it is evident that both healthcare providers, clinicians and vendors are not fully prepared for the October 6 deadline,” the letter states. “Therefore, we are respectfully requesting that HHS consider both postponing for a period of one-year the information blocking compliance deadlines—including October 6, as well [as] using corrective action warning communications to providers/clinicians prior to imposing any monetary disincentives or beginning a formal investigation.”
As of this writing, HHS has not replied to the letter.
The signers of the letter include major industry groups such as America’s Essential Hospitals, the American Academy of Family Physicians, the American Hospital Association and the American Medical Association.
“Our members have been working diligently towards meeting the upcoming—and rapidly approaching—October 6 information blocking deadline with the expanded electronic health information (EHI) definition,” the letter states. “Despite our best efforts to educate our members, significant knowledge gaps and confusion still exist within the provider and vendors communities with respect to implementation and enforcement of information blocking regulations.”
Healthcare has been notoriously slow to adopt new technology, and a recent headline in The New York Times about this issue captures that for many, patience is running out: “Very ‘Harmful’ Lack of Data Blunts U.S. Response to Outbreaks.”
The NYT article states that “decades of underinvestment in public health information systems has crippled efforts to understand the pandemic, stranding crucial data in incompatible data systems so outmoded that information often must be repeatedly typed in by hand. The data failure, a salient lesson of a pandemic that has killed more than one million Americans, will be expensive and time-consuming to fix.”
In an opinion piece published in Stat, Steven Lane, M.D. argues that HHS should stick to the original deadlines, if at all possible. Lane was a PCP for over 30 years and is now the chief medical officer of Health Gorilla, an interoperability platform.
He says that as “one of the earliest adopters of electronic medical records, I am admittedly at an advantage. But there has been plenty of time for everyone to prepare for this change. The fact is, interoperability can no longer wait, and information blocking is a serious impediment to providing safe, cost-effective, high-quality care in this country.”
In their letter, the provider organizations insist that they share the same goals for interoperability contained in the Cures Act, but they need resources—and education—to meet them.
“To improve the collective provider and clinician understanding of the information blocking regulations, we urge federal agencies under the HHS umbrella … to engage in more education targeted to the provider/clinician community with a particular focus on small, medium and lesser-resourced organizations," the organizations said. "Providers want and need best practices and implementation guides that they can reference as they strive to prepare for the investigation and disincentive phase of information blocking regulations. Without real-world guidance, providers will continue to struggle with implementing internal policies to avoid allegations of information blocking.”