AHCA, along with nine other organizations representing a coalition of a broad range of providers and clinicians from across the health care continuum, submitted a
letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. The letter requests that HHS consider postponing for a period of one-year certain information blocking compliance requirements due to be implemented on October 6, 2022. The letter also asks the Secretary to use corrective action warning communications to providers/clinicians prior to imposing any monetary disincentives or beginning a formal investigation.
Background
The 21st Century Cures Act (Cures Act) established new requirements that health care providers, health IT developers, health information exchanges (HIEs), and health information networks (HINs) are prohibited from engaging in “information blocking” practices. Beginning October 6, 2022, these actors must be able to share all electronic protected health information (ePHI) in a designated record set, as defined under the Health Insurance Portability & Accountability Act (HIPAA). Prior to this data sharing mandates are limited to what is contained in the USCDI.
Coalition members have been working diligently towards meeting the rapidly approaching October 6 information blocking deadline with the expanded electronic health information (EHI) definition. Despite efforts to educate members, significant knowledge gaps and confusion still exist within the provider and vendor communities with respect to implementation and enforcement of information blocking regulations. Based upon feedback from our members that continues to build, it is evident that health care providers, clinicians, and vendors are not fully prepared for the October 6 deadline.
The letter goes into further detail regarding the implementation challenges including:
- There is no clear definition of EHI and there is a lack of a technical infrastructure to support its secure exchange.
- There are widely divergent approaches to how each healthcare stakeholder is interpreting what data is ePHI, DRS, and EHI.
- Significant confusion continues to exist on how the eight information blocking exceptions are applied when EHI cannot or should not be exchanged.
- Providers and patients are also deeply concerned with harm occurring when laboratory results and reports are released in instances of life threatening or life limiting diagnoses.
- There are insufficient technical and policy guides to assist providers in protecting sensitive health records such as substance use disorder, adolescent, mental health, and reproductive information.
- Small providers/clinicians’ awareness remains very low, and they are relying heavily on their vendors.
- Vendor readiness is lagging, and certified vendors are tracking to their required timelines that don’t necessarily align with the provider requirements which is causing confusion and limitations on sharing of EHI data.
- ONC’s own data shows that only 26% of health IT products are certified.
- Providers want and need best practices and implementation guides from the government that they can reference as they strive to prepare for the investigation and disincentive phase of information blocking regulations. Without real-world guidance, providers will continue to struggle with implementing internal policies to avoid allegations of information blocking.
The letter further emphasizes that the signing organizations are supportive of the Department’s efforts towards increased interoperability and ensuring patients have access to their health data. Given the great importance of these policies, the coalition members want to make sure that they are implemented as smoothly and successfully as possible – for both patients and the clinicians and providers who care for them. In closing the letter states
“While remaining steadfast in our commitment to be partners with our patients and facilitate access to their records; the need for more time to ensure all providers and clinicians understand the policies, are prepared to meet them and have the technology to support these policies are critical.”