- The Trump administration is considering pushing back the timeline for payers, providers and health IT vendors to come into compliance with its two sweeping rules to promote interoperability as the healthcare system struggles with the novel coronavirus outbreak.
- "That is definitely something that is under consideration," Denise St. Clair, an analyst in CMS' Health Informatics Office, said Wednesday during a meeting of the Health IT Advisory Committee. "We are definitely thinking through all of the real and incredibly important work that everyone needs to be focusing on right now."
- However, some health IT experts are calling for more urgency, not less, to fix the outdated EHR infrastructure and allow the free flow of clinical data to combat the mounting public health emergency.
HHS is weighing adjusting the timeline so the health system can flow all its resources into fighting the pandemic, but members of the body that advises Congress and HHS on health IT policy think the Trump administration should be doing everything it can to give providers a cohesive picture of patients' health to get a handle on COVID-19.
"We are in a very, very, very unique situation," St. Clair said at the March HITAC meeting Wednesday. "We are assessing the situation and looking for feedback and we will definitely, I'm sure, have more to say."
Data sharing across platforms is essential during a public health crisis, experts say, so the government can get a holistic view of locations of confirmed cases, diagnostic test results, treatment outcomes and more. As of Tuesday, the Centers for Disease Control and Prevention said 75 people in the U.S. had died from COVID-19 and more than 4,200 tested positive, but those numbers are likely well behind the true number of cases due to a lack of widespread testing.
The HHS rules finalized March 9 require providers to open up their EHR systems through standardized application programming interfaces (APIs), allowing health systems and hospitals across the country to quickly and freely share information. That could allow providers to come closer to catching up with the virus, public health experts say.
Providers have to be able to share certain types of data, including clinical notes and patient demographic information, within just six months, and all electronic health data after 24 months. But a handful of HITAC members think the administration, instead of dialing back that timeline, should be ramping it up.
"In light of the coronavirus, it is even more imperative that we move faster," Cynthia Fisher, founder of advocacy organization PatientRightsAdvocate.org, said. "Can we do better than 24 months?"
And existing regulations designed to protect privacy have served as a bottleneck for researchers to find out what's going on on a national level. The U.S. is only testing a trickle of citizens — 125 people per each million, according to data from the COVID Tracking Project — and the CDC tests only record the result of the specimen, not information about the patient, so it's hard to aggregate and research how the outbreak is shifting.
"In this time of crisis, I wonder if there is regulation or tweaking of the intense concern about individual privacy that might be relaxed a bit to find out what is going on and stop people from getting sick," Clem McDonald, director of the Lister Hill National Center for Biomedical Communications at the National Library of Medicine, said.
As the U.S. moves to new containment and mitigation strategies like widespread social distancing, increased telehealth screening and drive-thru testing sites, its imperative the Trump administration finds a way to collate all that information and share it between relevant institutions like the CDC, FDA, health systems and researchers, experts said.
"We need to move forward on how to restructure privacy so that there can be frictionless information flow about test results and their clinical meaning across all responders," Les Lenert, chief research information officer at Medical University of South Carolina, said.