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  • Proposed Rules on Electronic Health Information Seek Better Patient Access, More Interoperability

    With the release of proposed rules aimed at increasing the interoperability of electronic health information (EHI) among insurers and eliminating EHI "information blocking" practices, the US Department of Health and Human Services (HHS) is sending a clear signal: it intends to move ahead with a push toward making it as easy as possible for patients to access their health care records from just about any device, for free. And it won't hesitate to name the names of facilities and insurers that aren't cooperating.

    In 2 separate but related proposed rules, the US Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC)—both agencies under HHS—laid out new requirements that, if adopted unchanged, would force improvements to patient EHI access by as early as 2020.

    The proposed rules, released February 11, are complex, and APTA regulatory affairs staff are reviewing the contents to prepare comments by the anticipated early-April deadlines. At the big-picture level, a few basic ideas are emerging.

    The CMS-generated rule would require Medicare Advantage, Medicaid, Children's Health Insurance Program, and Affordable Care Act plans to provide enrollees with immediate access to their medical claims and other information by 2020, and would allow CMS to publicize the names of facilities that make it difficult or impossible for patients to access these data, according to a CMS fact sheet. The proposed rule would also require health care providers and plans to use open data-sharing technologies to make it easier for people to move between different payers.

    The proposed rule from the ONC (fact sheet) would require that health care payers and providers move to standardized application programming interfaces—techspeak for systems that make it easier for individuals to access a variety of EHI on phones and other mobile devices. Additionally, the rule would target information-blocking practices that prevent patients from accessing their own records or apply a charge for providing them. The ONC proposal would ensure that access is unrestricted and free to patients.

    The proposed ONC rule also asks for comments on pricing information that could accompany EHI to help the public get a better idea of the cost of care. The CMS proposed rule includes a request for comments on how the agency can "leverage its authority to improve patient identification and safety to encourage better coordination of care across different healthcare settings while advancing interoperability." Those settings include long-term and postacute care.

    "In a general sense, the move toward greater EHI interoperability is a concept strongly supported by APTA, but with the proposed rules coming in at more than 1,000 pages combined, it will require some time to fully understand the impact these proposals may have on physical therapists," said APTA Director of Regulatory Affairs Kara Gainer. "Once we better understand the details of the CMS and ONC proposals, we will be able to provide a more complete perspective through APTA comments and other resources and updates."

    [Editor's note: Want to add your voice to the profession's take on interoperability? During the coming weeks, be sure to check APTA's "Regulatory Issues: Take Action" webpage for template letters that make it easy to share your perspective.]