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With pandemic, some groups disappointed in delayed interoperability rules

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New interoperability rules expected to publish in May would require hospitals and health IT companies to make it easier for patients and other organizations to access health records. The new rules were released by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) last month, with timelines that would require companies to move quickly to meet the requirements.

Now, because of the ongoing pandemic, those deadlines have been pushed back. While it no doubt relieved some pressure for hospitals, some health groups said the new rules are needed even more now to better handle the spread of Covid-19.

Earlier this month, nonprofit policy research organization Pew Charitable Trusts urged Department of Health and Human Services Secretary to move the rules forward without delay.  In a letter to HHS Secretary Alex Azar, Pew’s project director of health information technology Ben Moscovitch said the ongoing pandemic underscored the importance of the new rules, which would make it easier for patients to access their data through the use of common APIs, and require clinicians to better coordinate care by sharing information.

“For example, with mandatory stay-at-home orders and efforts to socially distance, patients lack the ability to go into a hospital or doctor’s office to pick up their records. Additionally, patients may be seeing new clinicians via telehealth for the very first time due to restrictions on in person office hours or because of their symptoms,” Moscovitch wrote. “What these patients share is a greater need to have remote access and exchange of their health data to make more informed healthcare decisions.”

Under the new timeframe, the ONC said it would “exercise discretion” in enforcing the new rules until three months after each deadline has passed. CMS, which would have required hospitals to share admission, discharge and transfer data within six months of publication, is giving them another six months to come into compliance.

The American Hospital Association said the additional flexibility from CMS was “encouraging,” but asked for more leeway from the ONC.

Claudia Williams, CEO of nonprofit health information exchange Manifest Medex, said she was disappointed to see the CMS rules delayed. They would require hospitals to notify a patient’s primary care physician when they are admitted to a hospital, discharged or transferred to another facility.

“This isn’t a nice-to-have. This is something that’s really central I think to the (Covid-19) response,” she said in a phone interview.

Some states, such as Maryland, already have similar requirements in place. But in California, where Manifest Medex is based, there are no such requirements. Out of roughly 350 hospitals across the state, only 140 of them are sharing data with health information exchanges, Williams said.

During a pandemic, this information could be particularly useful for tracking ER admissions and how many beds are being used. It could also make it easier to keep track of patients after they’re diagnosed with Covid-19.

“The pandemic has revealed the danger of not connecting data,” she said. “Interoperability in little silos doesn’t solve the problem when you need a unified response.”

If anything, the pandemic has highlighted the value of sharing information between healthcare providers, but hospitals need to put in the work to make it happen, Williams said. She described admissions, discharge and transfer data as the “meat and potatoes” of health IT systems.

“Every EHR can produce them. They’re very standardized. It really is a low lift and it provides so much value,” she said. “We’re really hoping that California will make our timelines be a lot more rapid that federal government did in their latest version of the regulations.”

Photo credit: Mutlu Kurtbas, Getty Images

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