Apple, Cerner call for interoperability rule release 'without further delay,' highlighting industry rift

Big tech giants Apple and Microsoft are joining health IT vendors and health plans to meet with federal officials today to voice strong support for efforts to give patients access to their health data.

The Carin Alliance, a private sector collaboration made up of major health insurers, providers, health IT companies and tech giants, announced last week that it is meeting with the Office of Management and Budget (OMB) OMB to request the agency to finalize and release the proposed interoperability rules "without further delay."

It came just days after the head of electronic health record (EHR) vendor Epic emailed CEOs and presidents of hospital systems urging recipients to sign a letter alongside Epic that voices disapproval for proposed interoperability rules from the Department of Health and Human Services (HHS).

Carin Alliance released a list of attendees for the Monday meeting and talking points (PDF) on its website Friday. Among the attendees are representatives from Apple, Microsoft,  Humana, Walgreens, Blue Shield of California, Salesforce, Omada Health, major health information exchange Manifest MedEx, and Mount Sinai Health System. Also on the list were representatives of Cerner, an EHR vendor and competitor to Epic.

RELATED: Epic CEO emails hospital customers urging them to speak out against ONC interoperability rule

About 40 people representing some of the biggest companies in the industry are planning to attend, either in person or by phone.

Many of the organizations are members of the Carin Alliance.

"Although we may slightly differ in the specific details regarding how the proposed rules should be implemented, we are united regarding the consumer access sections of the two proposed rules and in our belief that both proposed rules should be finalized and released immediately," the Carin Alliance said in the talking points. "It will be to the benefit of all stakeholders to finalize the rules so the industry can work on implementation while continuing to work with the public sector to improve the rules over time."

In February 2019, the Office of the National Coordinator for Health IT (ONC) issued a proposed interoperability and information-blocking rule (PDF) that defines the demands on healthcare providers and electronic health record (EHR) vendors for data sharing. The rule also outlines exceptions to the prohibition against information blocking and provides standardized criteria for application programming interface development. 

The ONC rule is currently under review by the OMB, the last step before publication. The Centers for Medicare & Medicaid Services' proposed interoperability rule (PDF) also is under review at OMB.

RELATED: Anthem, Humana along with Apple and Google testing API for patient access to claims data

During the ONC Annual Meeting in Washington D.C. Monday morning, Steve Posnack, Deputy National Coordinator for Health IT, said ONC's data-sharing rule would not be released during the annual meeting, taking place today and Tuesday.

The Carin Alliance said the organizations support the timely release of the interoperability rules "with the understanding that CMS and ONC have incorporated the consensus recommendations made by the public during the comment period and with the assumption the public and private sectors can work together to improve and build upon the rules after they are released."

Google was not listed as a meeting attendee, but the tech giant is among 20 organizations—including Apple, Anthem, Blue Cross Blue Shield, Cambia Health Solutions, and Humana—involved in an initiative to do “real-world testing” of an application programming interface (API) to standardize claims data sharing. 

RELATED: Health IT stakeholders calling for ONC, CMS to 'go back to the drawing board' on interoperability rules

Lobbying efforts to oppose the proposed regulation have ramped up in recent weeks. EHR vendor Epic has been the most prominent and vocal critic of the rule. Epic CEO Judy Faulkner emailed hospital chief executives last week urging them to speak out against the proposed ONC rule.

In the email, Faulkner wrote, that the company is "concerned that health care costs will rise, that care will suffer and that patients and their family members will lose control of their confidential health information."

Some health IT groups and even lawmakers have voiced disapproval of the proposed regulation, as written, including concerns about the burden on providers and vendors along with data privacy risks. 

The lobbying efforts have ignited renewed interest in the data-sharing rules, which were released a year ago, along with a lot of discussion and debate on Twitter.

Farzad Mostashari, M.D., former National Coordinator for Health IT and founder of Aledade, posted the results of an informal poll on Twitter last week that showed overwhelming support for the data-sharing rules.

Others took to Twitter to take a jab at Epic's letter to hospital executives. Arien Malec, senior vice president, R&D at Change Healthcare and a member of HHS' Health IT Advisory Committee, tweeted: