The CMS and the Office of the National Coordinator for Health Information Technology at HHS are seeking public input on ways to broaden the reach of health information exchange to providers and patients not currently or only marginally sharing healthcare information electronically.
A formal notice and request for information
about the extra efforts has been published in the Federal Register
. In particular, the joint request said, the lack of IT systems and, therefore, interoperability is most prevalent among long-term care, rehabilitation and psychiatric hospitals.
As such, the feds said, "HHS is considering a number of policy levers" and "intends to rely on all applicable and appropriate statutory authorities, regulations, policies and programs" to promote interoperability so that providers can use interoperability systems to exchange health information for care coordination across healthcare settings.
For example, the request authors said, under the Patient Protection and Affordable Care Act, state Medicaid and Children's Health Insurance Programs can provide health information exchange funding for home monitoring and care-delivery programs and provide an increase in the federal reimbursement rate for these services.
Health information exchange costs can also be built into the administrative costs of the largely federally funded Medicaid EHR incentive payment program, they said.
And, according to the RFI, the CMS could require that providers are able "to ensure timely, electronic exchange of health information to support patient admissions, discharge, and transfers as well as care planning," as conditions of participation or coverage in Medicare programs.
The CMS could also promote the use of Blue Button
, a program initially developed by the Veterans Affairs Department but since expanded to other federal agencies and the private sector, to provide patients with easy-to-use downloads of their medical records. Tools built on Blue Button Plus, an advanced version of the technology, "could be made available to all CMS beneficiaries," the federal statement said.
Modifications to the Clinical Laboratory Improvement Amendments, the main federal rule governing healthcare laboratories, and the Health Insurance Portability and Accountability Act, the main federal privacy law, could enable patients to directly access their lab results instead of going through their providers, the requesters said. The public comment period ends April 22.