New ONC & CMS Final Rules Present Biggest Push for Interoperability Yet

Learn how these updates could impact you and your patients

We are officially one significant step closer to achieving interoperability, thanks to the recent release of long-awaited final rules that address several provisions of the 21st Century Cures Act. The final rules from the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) are the most comprehensive policies the federal government has attempted to administer thus far regarding health care data, interoperability, and patient access.

The final rules emphasize the importance of ensuring that patients retain access to their own personal health information. However, they offer little guidance on how to handle situations where patients are cognitively impaired (think dementia or Alzheimer’s disease) and require that their information go through a surrogate decision-maker or power of attorney. This gray area leaves room for long-term/post-acute care (LTPAC) facility medical directors to collaborate with management to determine how to best address the issue for the patients under their care.

At the same time, physicians and other providers need to coordinate this data-sharing process with facilities and hospitals. One provision of the new rule requires that hospitals share specific patient information with LTPAC providers and facilities upon their transfer, ensuring a smooth hand-off that maximizes patient safety. When practitioners play an active role in determining the best flow of this communication of patient information between all entities, they can ultimately provide better quality of care.

Moving forward, practitioners and facilities alike need to consider how they will respond to these new rules and do so collaboratively. In their announcements, both CMS and ONC leaders made it clear that these communications are the way of the future and that the government is committed to improving interoperability.

“Delivering interoperability actually gives patients the ability to manage their health care the same way they manage their finances, travel, and every other component of their lives,” said ONC head Don Rucker, MD. “This requires using modern computing standards and APIs that give patients access to their health information and give them the ability to use the tools they want to shop for and coordinate their own care on their smartphones.”

In their overview of the final rule, CMS leaders said, “When a patient receives care from a new provider, a record of their health information should be readily available to that care provider regardless of where or by whom care was previously provided. When a patient is discharged from a hospital or post-acute care setting, there should be no question as to how, when, or where their data will be exchanged.”

In the coming months, as interoperability (or a lack thereof) proves to be a key issue in the nation’s response to the COVID-19 pandemic, GPM will offer additional guidance on how to ensure privacy as we move forward under these new rules. In the meantime, see this webpage from ONC and this webpage from CMS for some specific highlights of the rules.