Creating Info-Sharing Clarity Amidst Confusion

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Expanded info-blocking rule bodes well for patients, but continues to pose challenges for actors/healthcare stakeholders as they wait on further clarification 

clarity_confustion iconBarely a week has passed since the Office of the National Coordinator for Health IT (ONC’s) October 6th information-blocking rule expanded the definition of electronic health information (EHI). Hailed by many in the social media sphere as “Data Liberation Day,” the expansion of the rule is the culmination of a two-year process (nearly six years, if you look back to the passing of the 21st Century Cures Act) in which the federal government has endeavored to ease providers, payers, and health IT developers down a path of interoperable systems and painless data-sharing, all leading to, ideally, a patient-centric health care system and improved patient outcomes. 

Now, theoretically, patients can request and receive their designated record set in digital format on demand. Gone, again theoretically, are the days of waiting weeks, if not months, for paper copies of health records and CD-ROMS of medical images, if they could get them at all. And yet … 

While ONC’s recent efforts to clarify the nuts and bolts of the expanded rule are certainly a step in the right direction towards helping actors achieve full compliance, history - and human behavior - has shown us that healthcare tends to drag its feet when it comes to complying with federal mandates. (Hospital enthusiasm for adhering to the Hospital Price Transparency rule has left much to be desired.) As the October 6th deadline loomed, organizations like the American Medical Association and a consortium of healthcare trade organizations called for its delay, citing “scarce resources” among their members and “significant knowledge gaps and confusion … within the provider and vendor communities with respect to implementation and enforcement of information-blocking regulations.”  

Though ONC’s two-year preparation period may have seemed an ideal timeframe during which actors could prepare for the information-blocking rule’s expansion, those years happened to coincide with a global pandemic. Digging into the information-blocking rule, purchasing and/or upgrading systems, and taking time to educate staff on the ins and outs of sharing patient data at the drop of a hat took a back seat to COVID care, staffing shortages, and physician burnout – issues still being worked through at the ground level today. 

On many occasions, National Coordinator Micky Tripathi has expressed that “it’s definitely very complicated.” ONC continues to execute on efforts to further educate actors/healthcare stakeholders on complying with this rule, understanding its exceptions and yet-to-be-determined disincentives, and acting in good faith rather than from a place of HIPAA-induced fear.  

The office has said that it will continue to offer resources to help providers, payers, and health IT developers comply with the expanded rule, including:  

Though actors may be playing catch-up, patients and their advocates should be ecstatic about this effort. They should be clamoring for the data-sharing levers to be pulled. ONC’s efforts to push data-sharing to new levels of ease and accessibility, while complicated to execute, will improve patient care coordination and outcomes. Eventually, Data Liberation Day will truly arrive.  

As subject matter experts in healthcare IT, interoperability and federal and state health care policy, we have kept a close eye on how this has all unfolded and will continue to evolve. If you need help with your interoperability roadmap or understanding the variable state and federal policies that could impact your organization or how standards development work at HL7 (Health Level 7®) and NCPDP (National Council for Prescription Drug Programs) propel and intertwine with information sharing, reach out to us at kim.boyd@pocp.com