ONC's Cures Act Final Rule: First Wave Begins

CMS Meaningful Use rules ushered in the EHR era around a decade ago. After Meaningful Use payments expired many physicians realized that the burden of EHR use far outweighed the benefit of the short term payments related to initial adoption. CMS administrators designed a very proscriptive and sometimes punitive set of regulations with an eye on micromanaging how physicians were to relate to their EHR, vendors were directed to build “cars without the highways”. The extra time required to record patient data digitally always presumed the promise of an offset related to efficient, responsible and seamless exchange of health records. Instead without a fair set of rules that set the framework for interoperability, data became siloed in host systems. 

With the adoption of the 21st Century Cures Act, signed into law in 2016, the rewards of recording patient records digitally are about to pay off. ONC’s publication of the “Final Rule” on May 1, 2020 is a result of provisions included in the “Cures Act” and outlines two transformative rules. One aims to implement interoperability and the other to deliver on giving patients true access to their healthcare data, which is at the center of the evolution to a value-based healthcare system. These final rules establish the most comprehensive healthcare data sharing policies the government has ever brought forth. They require private and public healthcare sectors to allow patient information to flow freely. At the same time, keeping it private and protected. 

Information Blocking 

The ONC’s Final Rule first wave of changes begins November 1st, 2020, just a few weeks away. It identifies and finalizes new rules to prevent information blocking practices as required by the Cures Act. At the moment, a great deal of EHR agreements have language in the contract that enables the prevention of information sharing. The ONC final rule updates certification requirements for health IT developers and illustrates new guidelines to guarantee that providers using certified health IT can communicate about health IT user experience, security and interoperability without hindrance.

The ONC final rule also instructs electronic health record systems to furnish the clinical data required to encourage new and improved business models of care. The rule improves common data through the U.S. Core Data for Interoperability (USCDI). The USCDI is a regulated set of health data classes necessary for the nationwide exchange of health information. The USCDI includes clinical notes and medications, among other important clinical data, to improve the flow of electronic health information and ensure that the information can be effectively understood when it is received.

Patients, Doctors and IT Developers All Benefit

The second wave of changes begins July 2021, when organizations are expected to share data through application programming interfaces (APIs). EHR organizations that have already moved to API connectivity will have the advantage of offering care management opportunities to individual members or members from other health plans. By exposing FHIR compliant APIs, those organizations will not only meet the mandate, they will likely entice third party application or “app” developers early, to help create an environment of connectivity to drive better outcomes. 

Doctors

The Cures Act provisions will allow providers to choose software that helps them provide better care. Providers will benefit from a vibrant competitive marketplace where the choice of software services lies with them and not a health IT developer. The Cures Act will also make it easier for providers to switch EHRs and take their data along with them. This will make EHRs more competitive, and that competition will drive much needed improvement related to the user experience.

IT App Developers

The Act makes a significant effort to minimize third party app developer costs. The certified API requirements focus on standardized data sets, notably the U.S. Core Data for Interoperability (USCDI). The key upgrade to the core data set is that EHR vendors must make clinical notes available via a structured data format and exchange those notes via APIs. This upgrade to the core data set makes it simpler for IT developers like ForeSee Medical that use NLP technology to read clinical notes, to obtain higher quality (no blurry faxes or scans) output. It also makes it easier for doctors, that may want to switch EHRs to export clinical notes from their legacy EHR and re-upload them into a different, new EHR.

Patients

APIs are the backbone of nearly every smartphone app. The Patient Access API will allow individuals to securely and easily obtain and use their electronic health information using the smartphone app of their choice. With more complete data in their hands, patients can be more informed decision makers, and take this information with them as they move from plan to plan, and provider to provider throughout the healthcare system.

The Way Forward

The final rule lays the foundation for modern day technology to meet the demands of patients and providers. It advances the needs of health care providers, while also being a huge step forward for patients. This industry shift will require a collaborative environment for both IT and business to work closely and quicken delivery. Understanding one’s readiness will help an organization define the interoperability approach needed to be compliant.  

At ForeSee Medical, we are tracking all of the latest standards. Our HCC risk adjustment coding software was designed and built ready to exchange data that conforms with the 21st Century Cures Act mandate.

Blog by: The ForeSee Medical Team