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Washington Debrief: ONC Announces Forthcoming Industry Guidance on HIPAA, Interoperability Metrics

August 18, 2015
by Leslie Kriegstein, Interim Vice President of Public Policy, CHIME
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Federal Affairs:

ONC Announces Forthcoming Industry Guidance on HIPAA, Interoperability Metrics

Key Takeaway: Congressional inquiries and stakeholder frustration regarding the lack of meaningful data exchange have resonated at ONC and will result in additional resources for health providers.

Why It Matters: Last week the Office of the National Coordinator for Health IT (ONC) announced forthcoming efforts to clarify individuals' rights to access to their own health records and separate guidance to measure the interoperability of hospital IT systems.

Dr. Karen DeSalvo, National Coordinator for Health IT, explained that some healthcare organizations have cited federal privacy laws as a reason not to share health records with patients or their families. She explained that the forthcoming guidance materials, to be released later this year, will seek to clarify individuals’ rights to access their records under the Health Insurance Portability and Accountability Act (HIPAA).

Separately, in a presentation before the Health IT Policy Committee, ONC unveiled a draft of the interoperability measurement framework for examining both near-term and long-term information exchange activities at hospitals. The agency will publish its final interoperability measurement framework in the Interoperability Roadmap, to be released in the fall.

The framework examines how hospitals send, receive, find and use health information, as well as the availability for clinicians of electronic health information from sources outside the hospital.

Study Finds Data Exchange Increasing Among Hospitals

Key Takeaway: According to data released by the Office of the National Coordinator for Health Information Technology (ONC) from a 2014 provider study conducted by American Hospital Association (AHA), less than a quarter of hospitals have the capability to find, send, receive and use electronic data.

Why It Matters: The findings include three types of barriers to exchange health data — technical, operational and financial – with technical barriers being the top reasons cited by survey participants.

Within the technical barriers category, the inability for an exchange partner to receive patient data (59%) and the lack of capability of EHR systems to receive data (58%) were the top two barriers. Difficulties associated with finding a provider's address (45%) was the third most-common barrier to data exchange according to the survey.

The leading operational and financial barriers were complex workflow challenges to send data from the EHR system (30%) and the additional costs for exchanging with external providers (25%). In addition, more than 25% of hospitals said that recipients did not find the health data being exchanged to be useful.

According to the survey results, the large majority of hospitals have the IT infrastructure necessary for data exchange, with 75.5% reporting having a basic EHR system, up from 59.4% in 2014. Further, 96.9% of providers cited having Certified EHR Technology (CEHRT) in 2014, up from 94% in 2013.

Congressional Affairs:

CHIME Joins Stakeholders in Calling to Increase Cross-State Telehealth Use

Key Takeaway: Last week, CHIME joined 20 other industry stakeholders in support of a bill that would remove licensure restrictions on providers delivering care to Medicare patients using telehealth technologies.

Why It Matters: The use of telehealth is artificially restricted by Medicare and different state licensure laws, the TELEmedicine for MEDicare (TELE-MED) Act of 2015 (H.R. 3081) and (S. 1778) would remove the barriers to the utilization of telehealth services by allowing Medicare physicians to treat Medicare patients regardless of location without the burden and expense of obtaining multiple state licenses. The doctor must still be licensed in the state in which he or she is located. The bill simply lifts the burden on the physician to be licensed in every state where his or her patients may be.

In tandem letters sent to the House and Senate, the stakeholder group emphasized that this structure is not new in federal programs; Congress has passed laws allowing for the same system in the Department of Defense (DoD) and Department of Veterans Affairs (VA). The results are impressive. Within the VA, home telehealth services reduced bed days of care by 59% and hospital admissions by 35%.

The Senate bill, S. 1778, was introduced by Senator Mazie Hirono (D-HI) and Joni Ernst (R-IA). The House version, HR 3081, has 24 co-sponsors, including sponsors Devin Nunes (R-CA) and Frank Pallone Jr. (D-NJ). Both bills were introduced July 15.

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