Withstanding scrutiny around interoperability: What CIOs should consider

Editor’s note: This article is the first in a series that will explore the main challenges at the heart of interoperability in healthcare. In addition to this article on information blocking, the series will cover topics such as new expectations for what constitutes electronic health information, how modern technology can break down longstanding obstacles to sharing data and coordinating care, and how to work with third-party partners to overcome “last mile” barriers to interoperability.

Though the 21^st Century Cures Act was signed into law in 2016, its impact on interoperability in healthcare is now beginning to be felt. In October, the ONC’s information blocking rule reached its full scope, with providers now prohibited from blocking patient access to any of their electronic health information.

The Department of Health and Human Services (HHS), ONC’s parent agency, has yet to establish penalties for providers that withhold information from patients. However, that doesn’t mean providers can rest on their laurels. In fact, now’s the time for providers to assess where they are and where they need to be — and to determine whether their technology partners are prepared as well.

The Cures Act final rule regarding patient access built on requirements put into effect in April 2021 to prohibit information blocking among providers, vendors, and health information exchange (HIE) entities. Health systems must now make available all components of a patient’s designated record set, including images and other unstructured files, which were used to provide care. (Eight exceptions exist in cases such as harm prevention, privacy, or infeasible requests.)

Providers are admittedly subject to less scrutiny than vendors and HIEs. It’s only considered information blocking for a physician if there is “knowledge and intent to interfere with access,” as the American Medical Association (AMA) says.

Still, organizations should be taking steps to avoid information blocking, including:

• Review and update your compliance program. Recognize that you’ll need separate programs to cover information blocking as well as laws like the Health Insurance Portability and Accountability Act (HIPAA).
• Review and update policies related to requests for access, exchange, or use of medical information, especially when patients or their caregivers are making the request.
• Ensure your electronic health record (EHR) vendor is compatible with the HL7 Fast Healthcare Interoperability Resources (FHIR) Release 4 and is Cures Act certified to support advanced interoperability capabilities.
• Review how data is captured, stored, identified, and integrated across the organization. Consider establishing data quality metrics that can serve as a baseline and flag concerns that could lead to an inability to share standardized data.
• Assess your ability to share patient records in their requested format. Recognize that patients increasingly prefer the portal for accessing records over legacy formats such as CDs.
• Assess how well your organization can incorporate data from remote monitoring devices or other applications outside the EHR into the patient record.
• Identify non-certified EHR systems, billing systems, or other clinical applications that require workarounds to make data available.
• Ensure that executive leadership understands what the new requirements are, why they are in place, and what resources are needed to ensure compliance.

It’s only a matter of time before health systems will be held accountable for information blocking compliance – and potentially subject to fines or other punitive action. Taking the right steps today to determine if technology systems are ready and policy are up to date will help CIOs and their peers avoid headaches tomorrow.

About Consensus Cloud Solutions: Consensus Cloud Solutions, Inc. (NASDAQ: CCSI) has been a global leader of digital cloud fax technology for over 25 years. The company leverages its technology heritage to provide secure solutions that transform simple digital documents into advanced healthcare standard HL7 FHIR for secure data exchange. Consensus offers eFax, a global leader in online faxing, Consensus Unite and Consensus Harmony interoperability solutions, Consensus Signal for secure automatic real-time healthcare communications, Consensus Clarity, a Natural Language Processing (NLP)/Artificial Intelligence solution, and jSign for electronic digital signatures. For more information about Consensus, visit consensus.com. Follow us on Twitter @ConsensusCS.