Providers ask HHS to extend information blocking deadline for a year
There is a widespread inability to support the access, exchange and use of electronic health information, the groups say.
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Ten hospital and physician groups have asked Health and Human Services Secretary Xavier Becerra to extend the October 6 information blocking deadline for one year.
"Despite our best efforts to educate our members, significant knowledge gaps and confusion still exist within the provider and vendor communities with respect to implementation and enforcement of information blocking regulations," the groups said in Monday's letter to Becerra.
The groups also want HHS to send corrective-action warning communications to providers and clinicians prior to imposing any monetary disincentives or beginning a formal investigation.
WHY THIS MATTERS
Starting October 6, stakeholders are expected to share electronic health information, per rules issued by the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services.
Under the ONC Final Rule, providers, health IT developers, health information exchanges and health information networks were prohibited from engaging in information blocking practices.
It gave requirements on Application Programming Interface (API) functionality and Fast Healthcare Interoperability Resources (FHIR) adoption. The rule was later expanded, requiring information sharing with eight exceptions.
"Our members have been working diligently towards meeting the upcoming – and rapidly approaching – October 6th information blocking deadline with the expanded electronic health information (EHI) definition," the groups said. The groups told Becerra that a chief factor limiting compliance readiness is the widespread inability to support access, exchange and use of electronic health information. There is no clear definition of EHI, and there is a lack of a technical infrastructure to support its secure exchange, they said.
There are also widely divergent approaches to how each healthcare stakeholder is interpreting what data is electronic protected health information, what is a data repository service and what is electronic health information. Since they're being held accountable for EHI interoperability, consistency in EHI interpretation is critical, the groups said.
"Moreover, significant confusion continues to exist on how the eight information blocking exceptions are applied when EHI cannot or should not be exchanged," they said.
There are concerns in understanding the harm occurring when laboratory results and reports are released in instances of life-threatening or life-limiting diagnoses. There are also insufficient technical and policy guides to assist providers in protecting sensitive health records, such as substance use disorder, adolescent, mental health and reproductive information.
"We continue to monitor and review ONC's frequently asked questions, however, many of the questions we are raising are not clearly answered," they said.
In the letter, the provider groups said they appreciated HHS's ongoing efforts to advance health data exchange and interoperability while advancing health equity for all, but that it was evident that both healthcare providers, clinicians and vendors were not fully prepared for the October 6 deadline.
The letter was signed by America's Essential Hospitals, the American Academy of Family Physicians, the American Health Care Association, the American Hospital Association, the American Medical Association, the Association of American Medical Colleges, the Federation of American Hospitals, the Medical Group Management Association, the National Association for the Support of Long Term Care and the College of Healthcare Information Management Executives.
THE LARGER TREND
The ONC and CMS rules were meant to fulfill the interoperability and information-blocking provisions of the 21st Century Cures Act.
The CMS Interoperability and Patient Access Rule, issued in 2020, gave patients digital access to their protected health information. It applied mostly to payers by requiring them to implement and maintain a secure, standards-based HL7 FHIR API that allows patients to easily access their claims and encounter data, including cost, as well as their clinical information through third-party applications of their choice. Payers were also required to make provider directory information publicly available via a standards-based API.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
