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Washington Debrief: ONC Receives Praise and Criticism for Interoperability Roadmap

October 20, 2014
by Jeff Smith, Vice President of Public Policy at CHIME
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Jeff Smith, Vice President of Public Policy at CHIME

Top News

Interoperability Roadmap Hopes to Define Path to Better Exchange

Key Takeaway: The Office of the National Coordinator for Health IT (ONC) introduced a new set of details regarding their interoperability roadmap last week, garnering both praise and criticism during a joint meeting of the Health IT Policy and Health IT Standards committees. The committees also voted to adopt recommendations made by the JASON Task Force.

Why It Matters: The roadmap will be a four- to six-month effort to garner consensus on a host of standards and policies needed to make EHRs more interoperable and increase data liquidity. CHIME submitted comments during the initial public comment period and will provide further guidance as the roadmap develops.

ONC received both praise and criticism at a joint HIT Policy and HIT Standards committee meeting last week at which the agency released an initial draft of its Interoperability Roadmap. By 2017, providers and individuals should be able to “send, receive, find, (and) use a basic set of essential health information,” the roadmap states. Successive periods of six and 10 years would see the proliferation of more complex functionalities, including access to more granular information for treatment and research; increased automation for clinical decision support; and creation of longitudinal records.

As part of the discussion of “how to get to interoperability,” members of the JASON Task Force introduced their findings and offered recommendations for the Policy and Standards Committees to consider. The Task Force recommended that a solid foundation for interoperability should utilize public APIs, advance modern communications standards, such as HL7's Fast Healthcare Interoperability Resources (FHIR), and use Meaningful Use Stage 3 as a pivot point to initiate this transition. CHIME leadership offered support for the day’s proceedings. “Today's discussion and the recommendations of the JASON Task Force represent an evolution in thinking,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO. “The updated roadmap and the recommendations put forth by the JASON Task Force incorporate a tremendous amount of stakeholder input and articulate the challenges facing our industry much more completely than previous efforts.”

ONC will release the next version of the roadmap with committee feedback in January, and a roadmap for public comment is likely to be released in March.


OCR Delays Accounting of Disclosures Rule until 2015

Key Takeaway: Last week, the Office for Civil Rights (OCR) announced it will not issue a final rule on Accounting of Disclosures before the end of the year. The Department of Health and Human Services (HHS) announced it will seek another round of public comments on the controversial rule in coming weeks.

Why It Matters: The healthcare industry has been awaiting the final rule that would require organizations to give patients detailed reports about how their personal health records have been accessed and shared. The reluctance of OCR to issue a final rule is the direct result of providers’ efforts to educate government officials on overly burdensome reporting requirements.

The Health Information Technology for Clinical and Economic Health (HITECH) Act required HHS to update Health Insurance Portability Accountability Act (HIPAA) rules to provide patients the legal ability to ask for electronic summaries of how their protected health information (PHI) has been accessed and with whom it was shared. The proposed rule required covered entities to provide individuals who make requests with the dates of PHI disclosures, the names of individuals who received the PHI, and a description of the data disclosed and for what purpose, within 30 days of the request.

CHIME’s comments to OCR in July 2011 stressed that aggregating hundreds or even thousands of access events in any automated fashion is not realistic for most covered entities, let alone trying to do so across covered entities and their numerous business associates. CHIME urged OCR not to include Access Report requirements in the final rule, and if the Access Report requirements remained, only data gathered through certified EHRs should populate the reports.

The OCR issued the proposed rule in May 2011, mandating that covered entities generate electronic reports accounting for all disclosures of protected health information under HIPAA. The rule should have been effective Jan. 1, 2014.

CHIME News & Notes

Healthcare IT Leaders Embrace Federal Interoperability Plans

Key Takeaway: The federal government's top health IT advisors on Wednesday made important recommendations on how public and private stakeholders should progress towards interoperability in healthcare. Leaders from the College of Healthcare Information Management Executives (CHIME) and Health Level Seven International (HL7) embraced the recommendations of the JASON Task Force, calling them a significant step forward in achieving the promise of information technology in healthcare. CHIME and HL7 also highlighted the need to incorporate critical enhancements to standards currently under development for Meaningful Use Stage 3.