Will Your EHR Comply with the New Information Blocking Regulations?

The new Final Rule has implications for providers as well as patients

Interoperability could be considered the ultimate goal of healthcare technology. Clinically, it would achieve universally accessible patient records, leading to better health outcomes. Administratively, healthcare’s push away from volume to value payment models depends heavily on its potential administrative and clinical cost savings. A provision in the 21st Century Cures Act Final Rule, which will begin November 2, 2020, aims to bring down a potential barrier to interoperability that occurs at all levels, from the provider’s office to multi-million dollar EHR companies – data and information blocking. What is data and information blocking? It’s withholding patient health information, either intentionally or unintentionally, by making its access difficult.

The Department of Health and Human Services (HHS) sounded the alarm about information blocking in the Report on Health Information Blocking published in 2015. The report stated, “While many stakeholders are committed to achieving (interoperability), current economic and market conditions create business incentives for some persons and entities to exercise control over electronic health information in ways that unreasonably limit its availability and use.”

The report alleges that some stakeholders may engage in activities that impede the exchange of health information because it is in their financial interest to do so. For example, charging “fees for data exchange, portability or interfaces,” or creating platforms that “lock-in” users and effectively block electronic communications, leading to additional services and subsequent cost.

There is some debate about whether there are intentional barriers for data exchange or only “incompetence in the industry.” Nevertheless, the Final Rule mandates that providers and vendors cannot obstruct the exchange of information (data blocking) with:

  • Practices that restrict authorized access … between certified health information technologies
  • Implementing health IT in nonstandard ways … (that could) increase the complexity or burden of accessing, exchanging, or using electronic health information (EHI)
  • Restrict the access, exchange, or use of EHI with respect to exporting complete information sets or in transitioning between health IT systems
  • …Impede innovations and advancements in health information access, exchange, and use

What the Final Rule means for providers

Healthcare organizations and providers need to be aware that intentionally manipulating data exchanges that lead to waste or abuse are prohibited (for example, tests needing to be repeated because the data was inaccessible).

Another provision to be aware of is the requirement that developers create application programming interfaces (APIs) that allow “health information from such technology to be accessed, exchanged and used without special effort through the use of APIs or successor technology.” In terms of real-world use, this will drill down to three things for healthcare providers:

  1. Patients must have access to records that require no “special effort” to obtain; this means information cannot be siloed in different electronic locations. It also opens the door to third-party application developers – patient access to records through a smartphone may soon be available.
  2. All documents should be scanned into the patient record.
  3. Transferring information from one vendor system to another may soon become more straightforward, potentially creating smoother (and cheaper) billing operations.

What providers should look for in EHR partners

Although it’s vendors’ responsibility to ensure their technology aligns with the 21st Century Cures Act mandates, providers may want to confirm their software platforms are compliant. Features to look for include:

  • Compatibility with HL7 Fast Healthcare Interoperability Resources (FHIR) Release 4
  • Optimized patient portal features that allow sharing and downloading of records
  • The ability for patients to share or link their information to third parties, such as smartphone applications

Enforcement of the Rule

Although the official start date is November 2, the OIG will use its discretion to enforce the new regulations (especially considering the COVID-19 pandemic.) Now is the time to check with your EHR partner to confirm your technology will comply with the Act’s requirements, so both your practice and patients can benefit from the new interoperability rules.

Staying on top of the latest regulations can be challenging– using the right partner for electronic health records and medical billing software makes it easy. Contact us today at (412) 424-2260 or visit vowhs.com to learn how we can help optimize MIPS, streamline claims, and maximize revenue.

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