The Senate Health, Education, Labor, and Pensions (HELP) Committee May 7 held a hearing titled “Implementing the 21st Century Cures Act: Making Electronic Health Information Available to Patients and Providers, Part II.”
In his opening remarks Chairman Lamar Alexander (R-Tenn.) urged the Trump administration to not go too far, too fast in electronic health records, and called for a delay in implementing two new interoperability rules, stating that “we don't want to prevent moving ahead, or progress, but I think we also have to be very cognizant of the challenges that providers and others are facing trying to do this complex work.”
Alexander continued, “I want to make sure we learn lessons from implementing Stage 3, which was, in the words of one major hospital, ‘terrifying.’ I am especially interested in getting where we want to go with input from doctors, hospitals, vendors, and insurers, so we have less confusion, make the fewest possible mistakes and make sure we don’t set some kind of unrealistic timeline. Because these are complex rules, I asked CMS and ONC to extend the comment period, and I am glad to see they have done so and want to thank our witnesses for allowing more time for comment.”
As part of the Centers for Medicare and Medicaid Services (CMS) rule stemming from the 21st Century Cures act (P.L.114-255), insurers participating in Medicare, Medicaid, and the Affordable Care Act exchanges would have the capability to give patients electronic access to their personal health information at no cost to patients by Jan. 1, 2020. The second rule released by the Office of the National Coordinator for Health Information Technology (ONC) addresses information blocking, and would provide standardized criteria for application program interface (API) development as well as prohibit information blocking. Both of these rules require the adoption of standardized APIs within two years after the completion of the rules. Hospitals would also, as a condition of participation in Medicare and Medicaid, be required to send admission, discharge, and transfer notifications.
The Department of Health and Human Services (HHS) extended the comment period deadline by 30 days for both rules after opposition to the timeline from stakeholder groups [see Washington Highlights, April 19].
Ranking Member Patty Murray (D-Wash.) largely agreed with the Chairman, and emphasized patient privacy, stating that “patients should be able to expect tech companies are going to use their most sensitive information responsibly, and give them the tools they need to be able to control how and when their information is disclosed.”
Donald Rucker, MD, National Coordinator for Health Information Technology Office of the National Coordinator for Health IT, addressed the Committee by both lauding the progress that has been made in electronic health records, and also recognizing the challenges that it has faced. Rucker stated that “fragmented care can lead to hospital readmissions, medical errors, and poor health outcomes, especially among patients with multiple chronic conditions who rely on coordinated care to help manage their health.”
Rucker also struck a hopeful tone, noting that apps have the possibility to improve care for many, continuing that, “mobile apps will provide individuals with access to their own electronic health information (EHI) that can follow them across providers and health plans, and advance an app marketplace that addresses unique patient needs. For instance, an app may empower patients with multiple chronic conditions to consolidate and share their care journey with each clinician they visit, potentially preventing adverse and life-threatening events due to missing clinical information.”
The other witness on the panel, Kate Goodrich, MD, director and CMS chief medical officer, highlighted the patient-centered approach that her division is taking in their app development. She detailed the successes of the “MyHealthEData Initiative, which aims to break down the barriers that prevent patients from gaining electronic access to their health information from the device or application of their choice, empowering patients and taking a critical step toward interoperability and patient data exchange.”