HHS Issues Two Interoperability, Data Sharing Rules Applicable to Hospice

Two final rules released by the U.S. Department of Health and Human Services (HHS) are designed to improve information technology interoperability among health care providers, including hospices, as well as provide patients with greater access to their own health data. The two regulations will be administered by the Office of the National Coordinator for Health Information (ONC) and the U.S. Centers for Medicare & Medicaid Services (CMS).

The agencies developed the rules pursuant to provisions of the 21st Century Cures Act, passed by Congress in 2016. These rules require public and private organizations to share health information between patients and other parties while ensuring the privacy and security of those data.

“Delivering interoperability actually gives patients the ability to manage their health care the same way they manage their finances, travel and every other component of their lives. This requires using modern computing standards and [application programing interface] that give patients access to their health information and give them the ability to use the tools they want to shop for and coordinate their own care on their smartphones,” said Don Rucker, M.D., national coordinator for health information technology. “A core part of the rule is patients’ control of their electronic health information which will drive a growing patient-facing health care IT economy, and allow apps to provide patient-specific price and product transparency.”

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Among other provisions, the ONC final rule establishes new rules to prevent information blocking by health care providers, developers of certified health IT, health information exchanges, and health information networks as required by the Cures Act. Currently, many EHR contracts contain provisions that either prevent users from sharing information related to the EHRs in use, such as screen shots or video. The ONC final rule updates certification requirements for health IT developers and establishes new provisions to ensure that providers using certified health IT have the ability to communicate about health IT usability, user experience, interoperability, and security including (with limitations) screenshots and video.

“Allowing hospice providers to be able to interact electronically with their referral sources and the other folks in the community that see those patients is very important, so challenge number one is closing the communication gap,” Nick Knowlton, vice president of business development for the technology firm Brightree, told Hospice News. “Care is delivered much more smoothly by hospice organizations when there’s interoperability between them and their referral sources. The ability to talk the talk and walk the walk with referral sources can have a direct bottom line impact.” 

The CMS Interoperability and Patient Access final rule requires health plans in Medicare Advantage, Medicaid, CHIP, and through the federal exchanges to share claims data electronically with patients.

“The days of patients being kept in the dark are over,” said CMS Administrator Seema Verma. “In today’s digital age, our health system’s data sharing capacity shouldn’t be mired in the stone age. Unfortunately, data silos continue to fragment care, burden patients, and providers, and drive up costs through repeat tests. These rules begin a new chapter by requiring insurance plans to share health data with their patients in a format suitable for their phones or other device of their choice. We are holding payers to a higher standard while protecting patient privacy through secure access to their health information.”

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