In March, the Department of Health and Human Services passed sweeping interoperability rules that would add teeth to requirements for healthcare providers and IT vendors to securely share patient health information. With the initial deadline approaching in November, is HHS facing pressure to push the deadline back?
“We’ve had lobbying pressure all along,” Dr. Don Rucker, National Coordinator for Health Information Technology, said in a Thursday panel at CB Insights Future of Health. “These are all powerful economic forces. Whenever you disrupt powerful economic forces in D.C., the town business is lobbying.”
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Recent lobbying disclosure reports confirm Rucker’s comments. Health IT companies paid lobbyists in the second quarter of 2020 related to interoperability and information blocking rules. D.C.-based lobbying firm Mehlman Castagnetti Rosen & Thomas, received $60,000 from Epic Systems, and athenahealth reported spending $60,000 on its own lobbying efforts.
Several other familiar names in healthcare spent lobbying dollars related to information blocking in the second quarter, including the American Hospital Association and Humana.
The new rules would require healthcare providers to give patients access to their health information — including clinical notes — and cease information blocking. Health record systems must also be able to connect with third-party software through standard application program interfaces (APIs).
“In terms of adjustments, all I can say at this point is we’re actively aware of the Covid-19 pandemic and looking at any needed changes,” Rucker said.
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Back in January, Epic Systems and several hospitals pushed back against the proposed rule, saying patients could share their health data with outside apps without realizing it might no longer be protected under HIPAA. Since then, Epic has reversed its position, but groups representing hospitals and healthcare executives have pushed for more time.
To an extent, that has been granted. In April, the Centers for Medicare and Medicaid Services pushed admission, discharge and transfer notification requirements back to spring of 2021. Hospitals will be required to notify a patient’s primary care provider if they were admitted to the hospital, discharged or transferred to another facility.
As for the information blocking requirements, the Office of the National Coordinator for Health Information Technology (ONC) has said it will exercise discretion in enforcing them for the first three months.
Interoperability and telehealth
If anything, the Covid-19 pandemic has highlighted the importance of accessing patient data, whether for tracking available ICU beds or referring a patient from a telehealth visit. As health systems turn to telemedicine tools, many still don’t connect with patient records.
“When folks think about telehealth, don’t just think about the visit. … Think about the entire experience that surrounds it. How is the caregiver on the phone or video getting information on my background or do I have to reenter it? How are they getting my medication list? How are things like services, prescriptions, lab orders, diagnostic tests, how are they being ordered? How is follow-up being coordinated?” Rucker said. “All of those things really require robust interoperable APIs. So, I think Covid has really shown the importance of this.”
Looking to the future, Rucker hopes to see an “app economy,” similar to those seen in the airline and banking industries, but for healthcare. He also expects to see the rise of big consumer brands as patients decide where they want to take their data, pointing to how Apple advertises its privacy protections compared to competitors.
“We’ve built in security provisions, encryption provisions and privacy protection provisions. That said, patients still have to be careful,” he said. “I am optimistic that there are many things that can happen here.”
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