- The Trump administration has extended dates for hospitals and EHR vendors to comply with its information sharing and interoperability rules for a second time as the COVID-19 pandemic continues to stress the nation's healthcare resources.
- The move was expected — rumors swirled for a few weeks amid public comments from top health IT officials and a proposed rule with a title hinting at deadline extension in September — but represents a significant increase in the timeline for compliance, especially compared to the short three-month extension announced in April.
- Thursday's interim final rule follows worries from providers and health IT groups that they wouldn't be able to meet the looming deadline on Monday to be able to exchange certain types of medical data with other providers, HHS' Office of the National Coordinator for Health IT said. It is extending that date, and dates for the Conditions and Maintenance of Certification provisions requiring EHR platforms to be able to integrate with third-party apps and other systems, until April 2021.
Some provider groups, notably the American Hospital Association, have been calling for added leniency from the federal government to comply with its sweeping data-sharing rules, noting the pandemic's ongoing stress on providers is unlikely to let up anytime soon.
ONC's rule standardizes application programming interfaces and updates the 2015 Edition certification EHR criteria to ensure IT systems send and receive data in a synchronous manner, while allowing patients to export and view their medical information.
Thursday's interim final rule extends the compliance dates and establishes new future applicability dates for the information blocking provisions. It also adopts updated standards and clarifies some key tenets of ONC's information blocking regulation, the agency said.
ONC took into account a number of factors, including the need to divert resources, whether workforces would need more time for training and implementation and HHS Secretary Alex Azar's extension of the public health emergency in October when deciding on the new timeline.
ONC's decision was relatively down to the wire, as the closest compliance date is this Monday.
"To be clear, ONC is not removing the requirements advancing patient access to their health information that are outlined in the Cures Act Final Rule. Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on COVID-19 response," ONC Chief Don Rucker said in a statement.
Originally, compliance with information blocking and associated conditions of certification, requiring providers and EHR vendors to freely share information, were required by Monday. However, that key deadline has now been pushed back to April 5, 2021.
Another important deadline, for vendors and other stakeholders to adopt standardized APIs, was originally May 2022, extended three months and is now Dec. 31, 2022. Vendors won't have to export electronic health information until Dec. 31, 2023.
Other EHR attestation dates for certification were pushed back by one calendar year.
The rule has not yet been published in the Federal Register, and has been under review by the Office of Management and Budget since September.
HHS first delayed the requirements in April, despite many stakeholders saying the timeline was achievable, even during the pandemic. ONC exercised its enforcement discretion and bumped back each initial date or timeline by three months for the new requirements, while CMS tweaked some deadlines for its interoperability rule, which largely builds on ONC's.
The original interoperability rules were finalized in early March following months of controversy, as officials tried to walk the thin line between patient access and the privacy of sensitive health information. Many health IT experts called for a speedier timeline amid the pandemic, as the nation's inability to share data in real-time complicated efforts to quickly respond to COVID-19 outbreaks and stymie the spread of the virus.