Electronic Health Reporter

By Courtney Tesvich, vice president of regulatory, Nextech.

Data interoperability is once again poised to take a giant leap forward and there are many factors propelling this evolution. For example, the Office of the National Coordinator’s (ONC) March 2020 introduction of the interoperability rule as part of the 21st Century Cures Act is set to advance interoperability regulations. COVID-19’s spotlight on the need for data transparency and seamless information exchange to enable efficient care delivery across diverse settings is revealing a critical use case.

The rapid onboarding and use of telehealth to virtually deliver safe and secure healthcare underscores the importance of modernizing interoperable solutions. Given all these factors, the time is right for healthcare organizations to evolve their thinking around data sharing.

While larger, multi-setting health systems may have teams of people dedicated to advancing their organization’s interoperability strategy, smaller entities (including specialty physician practices) are often left to figure out the right path forward on their own. This can be overwhelming, and it may be tempting for smaller organizations to delay work on this issue. However, it will only postpone the inevitable.

Over the next two years, the capabilities and requirements to exchange electronic health information will change drastically. The ONC is allowing two years to implement the new interoperability requirements and technology will likely change in that time. So, starting the effort now can make it easier to adapt as solutions evolve. The bottom line? To meet this deadline, practices need to develop their strategies, update compliance efforts, understand upcoming changes and begin to update processes to ensure they are fully prepared for the near future.

But how can an organization get started? Here are a few steps to consider.

Educate yourself on the intent and nuances of the ONC rule. The primary goal of the interoperability rule is to give patients greater access to their health information and allow them to share the data more easily with all providers. As electronic health record (EHR) vendors continue to develop their products to meet the updated requirements, more information than ever before will be available electronically both for patient use and for exchange. Factors that providers should be aware of include:

• Future availability of free text notes in the patient portal as well as nearly all lab, radiology and pathology results. As EHR vendors develop and certify to the US Core Data for Interoperability requirements, patients will see additional data beyond the previously available CCDA information in their portal, including visit notes.
• Patients will be able to seamlessly select independent apps to aggregate their own health records.
• Ensure your practice understands how to handle requests for information in a timely manner. This includes requests by patients for their data as well as data requests by insurance companies, employers and consumer-facing apps. Develop a policy and train staff before the new Information Blocking deadline of April 5, 2021. Ensure you continue to follow HIPAA guidelines as well.
• Practices will also need to regularly update clinician information in federal databases.

These suggestions merely scratch the surface of what the new rule requires. Providers should delve deeper and make sure they are moving towards compliance and not inadvertently standing in the way of information exchange.

Check what your IT vendor is doing to meet the ONC’s requirements. Vendors have a lot of responsibility in meeting the new rule. Reaching out and asking about their plans can be helpful to get a sense of their priorities and strategic considerations. At minimum, a vendor should:

• Be ONC certified to the current 2015 version requirements and actively working to update software to meet the requirements of the 2015 Cures Update. Your software provider will need to recertify to the new edition, and you will need to be using this updated software to participate in the Quality Payment Program in 2023.
• Be working to update APIs to HL7 Fast Healthcare Interoperability Resources (FHIR) Standard Release 4, which has been adopted by the ONC as the standard language of interoperability.
• Enable mobile app integration to allow patients easier access to their health data on the go.

Maintaining an open line of communication is essential to understanding how your vendor is updating their systems and what changes will be required by your practice. This allows for better preparation for potential policy updates, workflow changes and training requirements.

Verify that your telehealth strategy aligns with interoperability goals

When the COVID-19 pandemic first began, and CMS relaxed its telehealth rules, some practices began using common virtual communication platforms for telehealth. However, there are a number of privacy and security issues associated with the continued use of non-secure platforms to perform telehealth services.

As cases continue to rise at a precipitous rate, providers may need to further rely on their telemedicine solutions. As such, it is beneficial to use a system designed specifically for healthcare. These types of systems ensure data privacy and security by following all HIPAA requirements.

When these systems are embedded in current EHR solutions, they offer one-click functionality for providers and patients. Patients can use the technology more easily, and clinicians are able to participate and document telehealth within clinical care workflow. Data can be shared efficiently throughout the organization, including between providers and across departments. When technology is fully integrated, a virtual visit can more closely follow an in-person visit, with scheduling solutions, telehealth platforms, clinical systems and billing systems all working seamlessly together. This degree of interoperability is not something a virtual meeting platform could ever support.

The industry has moved beyond “nice to have”

Although the push for greater interoperability has been happening for a while, healthcare is closer than ever to realizing the goals of smooth information exchange. Physician practices and other smaller healthcare organizations that may have delayed pursuing interoperability must now commit to exploring the ONC requirements, gauging their practice’s current state of interoperability and developing a strategy to move forward. Not only is this important to maintain compliance with the 21^St Century Cures Act, but it is also crucial to remain competitive in today’s healthcare marketplace, where patients are demanding easier access to their health information and seeking providers who are committed to the same.