The Health IT Advisory Committee met on Wednesday to discuss the possibility of pushing back both the ONC and CMS interoperability rules due to the spread of the coronavirus.
The Department of Health and Human Services (HHS) may be push back the original timeline of the Office of the National Coordinator for Health Information Technology (ONC) interoperability rule, due to the COVID-19 pandemic.
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Since the ONC’s rule dropped on March 9, the coronavirus has spread rapidly across the country, forcing the Trump Administration to potentially make a difficult decision regarding the final rule.
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“That is definitely something that is under consideration,” said Denise St. Clair, a program analyst in the Center for Medicare and Medicaid Services’ (CMS) health informatics office at a Health IT Advisory Committee meeting on Wednesday. “We are definitely thinking through all of the real and incredibly important work that everyone needs to be focusing on right now.”
Not only would the ONC interoperability rule be pushed back, but the agency is also evaluating whether to delay the timeline for the CMS rule, focused on providers and payers.
“We’re in a unique situation and we’re thinking through all the real and incredibly important work that everybody needs to be focusing on right now,” continued St. Clair. “That is something that is definitely under consideration. We’re assessing the situation and looking for feedback.”
Originally proposed in February 2019, the ONC rule supports patients accessing and sharing their electronic health information, allowing them the ability to coordinate their own healthcare.
The rule also prohibits information blocking and aims to hold health IT developers, such as EHR vendors, accountable as a condition of certification.
Information blocking is defined as the intentional withholding of patient health information either from provider to provider or provider to patient. This has long been a touchy subject, with some industry experts questioning what exactly qualifies as “intentional.”
However, some health IT stakeholders said the process should be accelerated to help ease the spread of COVID-19, citing the importance of interoperability during a pandemic.
“Can we do better than 24 months?” said Cynthia Fisher, a member of the Health IT Advisory Committee. “In light of this coronavirus, it’s even more imperative that we move faster.”
The timeline for certain health IT organizations varies from six months to 24 months. Health information exchanges have a six-month timeline to implement the specific changes, while EHR vendors have 12 to 24 months to implement the changes and receive certification.
“We’re in an incredible shapeshift of how healthcare will be delivered, with taking care of people in their homes, with the new level of remote care, and bringing on national access for physicians to do telehealth,” Fisher continued. “It behooves us to come together and do better.”
Either way, the spread of the coronavirus has put the importance of health data exchange and interoperability under a microscope.
Niam Yaraghi, a fellow in governance studies at the Center for Technology Innovation at Brookings Institution, wrote an op-ed to explain why he thinks the US lacks health information technologies to stop or contain the COVID-19 epidemic.
“The pandemic has shattered our common beliefs about the type and scope of health information exchange (HIE),” wrote Yaraghi. “It has shown us that the definition of health data should no longer be limited to medical data of patients and instead should encompass a much wider variety of data types from individuals’ online and offline activity. Moreover, the pandemic has proven that healthcare is not local.”
He noted the importance of a nationwide HIE system and explained how the ONC interoperability rule and the CMS rule are major steps toward creating a nationwide HIE network.
Yaraghi went on to say that for a pandemic of this size to be contained, HIEs need to be executed on a national or international scale, rather than a small geographical scale.
“I believe these rules are huge steps towards a nationwide health information exchange system,” he concluded. “Policy makers should in the meantime consider replacing regulations that hinder the exchange of health data outside of the healthcare market with the ones that protect the privacy of patients in a more compatible way with today’s technologies and demands.”