CMS and ONC Propose New Rules to Improve Interoperability of EHI

Samara Rosenfeld
FEBRUARY 11, 2019
interoperability, EHI, data sharing

Today the U.S. Department of Health and Human Services (HHS) proposed new rules to improve the interoperability of electronic health information (EHI).

The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued the rules and claim that they would increase choice and competition while promoting patient access to and control over their health information.

“These proposed rules strive to bring the nation’s healthcare system one step closer to a point where patients and clinicians have the access they need to all of a patient’s health information, helping them make better choices about care and treatment,” said Alex Azar, HHS secretary.

>> READ: What Is Being Done About Healthcare's Lack of Interoperability?


Accessing Electronic Health Information at No Cost

According to the announcement, ONC’s rule would require that patients have electronic access to their health information at no cost. The rule also asks for comments on pricing that could be a part of an individual’s EHI and would improve price transparency. And the rule promotes more secure and immediate access to health information for patients and their healthcare providers, along with new tools that give patients more say in their care and treatment.

ONC’s rule calls on the industry to adopt standardized application program interfaces to help allow patients to securely and easily access structured and unstructured EHI via a smartphone or another mobile device. Additionally, the rule will implement the information blocking provisions of the 21st Century Cures Act that identifies reasonable and necessary activities that do not call for information blocking.

“The rule would support patients accessing and sharing their (EHI), while giving them the tools to shop for and coordinate their own healthcare,” said Don Rucker, M.D., national coordinator for Health information technology (IT).


Using Open Data Sharing Technologies to Improve Outcomes

CMS’ changes support the MyHealthEData initiative — which aims to empower patients by ensuring that they control their healthcare data and can decide how their data are going to be used — and would increase the seamless flow of health information, reduce burden on patients and providers and foster innovation by providing more data to researchers and innovators.

CMS is proposing that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges be required to provide enrollees with immediate electronic access to medical claims and health information electronically by 2020.

The rule would also require these healthcare providers and plans to use open data sharing technologies to increase interoperability as patients move between different plans.

Increasing interoperability would lead to reduced burden and would eliminate redundant procedures and testing, giving clinicians more time to focus on the patients and improve health outcomes.

With the proposed rule requiring health insurers to share their information in an accessible way, 125 million patients will have electronic access to their health claims information, CMS Administrator Seema Verma said in a statement.

“These steps forward for health IT are essential to building a healthcare system that pays for value rather than procedures, especially through empowering patients as consumers,” Azar said.

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