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 Feds Get Serious About Patient EHR Access from All Providers

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to support its MyHealthEData initiative to improve patient access and promote electronic data exchange and care coordination. The agency said the Interoperability and Patient Access Proposed Rule outlines opportunities to make patient data more useful and transferable via open, secure, standardized, and machine-readable formats, while reducing burdens on health care providers.

In addition to the draft rule, CMS issued two Requests for Information to get feedback on interoperability and health information technology (health IT) adoption in post-acute care settings, and the role of patient matching in interoperability and improved patient care. Patient matching refers to a process of comparing data from different health IT systems to see if data sources match and belong to the same patient. The match allows for better care coordination.  

In reviewing the CMS proposals, one long term and post-acute care (LT/PAC) health IT expert tells Provider the moves are a clear sign of the seriousness in which the feds regard patient access to data from all provider settings.

“The CMS administrator [Seema Verma] has continued her pursuit of expanding access to health information by directing the Office of the National Coordinator [ONC] to propose a series of new requirements on providers, payers, and state Medicaid agencies intended to enhance interoperability and access to health care information by the patient,” says Steven Chies, lead consultant, Care Paradigms, and president, North Cities Health Care, based in Minnesota.

He says of interest to the LT/PAC sector are the following:

--ONC is serious about mandating patient access via portals for all health care providers.

--ONC is proposing Medicare/Medicaid paying agencies use Application Programing Interfaces (APIs) to enhance access, similar to the federal Blue Button 2.0 model.

--ONC is mandating that state Medicaid agencies increase their capabilities on data exchange to a daily basis.

--The rule has language directed at hospitals and critical access hospitals in the Conditions of Participation to support care transitions using electronic and technology tools.

--ONC is looking to facilitate a scalable and perhaps universal “patient matching” solution so that health records and the patient are connected more easily and accurately.

Separate from the CMS announcement, Healthcare Leadership Council (HLC) and Bipartisan Policy Center released a report that recommended public- and private-sector actions to advance health IT interoperability, echoing some of the same themes as the proposed CMS rule.

“Critical patient information is getting lost in translation when doctors and other clinicians try to share it across health systems or state lines,” said Mary Grealy, HLC president. “This has detrimental effects on patient care because a clinician may not have the full picture of a patient’s history, or worse, has the wrong history altogether.”

Report recommendations include:

--Improving the business case for interoperability through collaboration among payers and providers, as well as providers and their health IT vendors, to agree on and implement shared expectations for interoperability, which can come in model contract language or other ways.

--Strengthening the technical infrastructure for interoperability by adopting common, baseline standards to improve patient matching across systems.

--Voluntarily adopting a common “notice of information access” and aligning consent policies for substance use disorder treatment under 42 CFR Part 2 (a federal law governing confidentiality for people seeking treatment for substance use disorders from federally assisted programs), as well as state privacy laws with HIPAA  [Health Insurance Portability and Accountability Act] to make it easier for individuals and their providers to gain access to data.

--Expanding public- and private-sector collaboration on measuring interoperability progress and developing and executing private-sector actions to drive improvements.

Read more about the CMS proposed rule at

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