- CMS is committed to requiring providers to use 2015 Edition certified EHRs in 2019 because that version opens APIs, a key ingredient in the effort to achieve full interoperability in healthcare, agency Administrator Seema Verma told industry on Monday.
- Speaking at the Office of the National Coordinator for Health Information Technology Interoperability Forum in Washington, D.C., Verma said too many doctors are still recording notes on paper and faxing patient records to other providers. She challenged health IT developers to "help us make every doctor's office in America a fax free zone by 2020!"
- Separately, more than a dozen members of the broad-based coalition Health IT Now sent a letter to the ONC and the Office of the Inspector General warning that it is "past time" to implement the data blocking provisions of the 21st Century Cures Act.
Verma has been consistent in speeches this year warning providers they should embrace methods for improving data sharing and work with the agency instead of fighting regulations. Such rules are still a work in progress, however.
The coalition pointed out that it's been 601 days since the Cures act was signed into law by President Barack Obama in December 2016. Among other provisions, the law requires HHS to issue regulations to prevent data blocking and to clarify kinds of activities that do not constitute information blocking.
"Every day that the administration delays implementation of these critical provisions places patients at risk of harm," the letter reads. "Information blocking impedes provider access to the most current, accurate, or complete information on their patients. As the administration proposes and implements new rules related to open APIs and interoperability in Medicare’s payment rules for hospitals and doctors, the lack of clear rules of the road needlessly creates uncertainty for vendors and providers alike."
During HIMSS18, Verma told a packed room of healthcare leaders that information blocking would no longer be tolerated. “Let me be crystal clear, the days of finding creative ways to trap patients in your system must end,” she said.
ONC Chief Don Rucker recently indicated in a Health Affairs article that the law's information-blocking provisions would be implemented "over the next few years." In opening remarks at Monday's forum, Rucker said rulemaking on information blocking and exceptions to it is a "work in progress."
Full interoperability depends on implementation of open APIs, Verma stressed. "By committing to the 2015 Edition of EHR certified technology, we are opening the door to innovators in this room to solve our most confounding challenges," she said.
Verma ticked off a list of actions CMS is taking to improve interoperability and data sharing, including the MyHealthEData initiative and incentivizing doctors and hospitals to give patients electronic access to their health records. The agency is also considering requiring providers to share data with patients in a "universal electronic format" as a condition of participating in the Medicare program, she said.
The agency is also looking at way to require or incentivize interoperability among participants in CMS' value-based payment models, Verma said.
In a JAMA viewpoint published Monday, authors from Harvard Medical School and Kaiser Permanent Northern California suggested health systems create data enclaves to enable sharing of information with external partners. Such enclaves address major barriers to data sharing because they use data derived from patient records rather than the actual patient records, eliminating the need to build new secure systems.
"Multiple enclaves from different health systems could be linked to create distributed data networks in which the systems format their data identically, then execute identical analytical programs on their own data," the authors wrote. They note that some existing distributed data networks include information of more than 100 million people, "enabling important collaborations that would have been difficult or impossible if comprehensive individual-level data sets had to be shared."