CMS, ONC officials hit HIMSS to tout interoperability rules

(Updated at 8 pm)

ORLANDO, Fla.—A day after releasing two significant proposed regulations, leaders from the CMS and the Office of the National Coordinator for Health Information Technology spread out across HIMSS19 in Orlando to talk up what they say will finally put patients in the driver's seat.

"We had two big goals. One transcendent goal was to empower patients to control their healthcare," ONC head Dr. Donald Rucker said during a media briefing Tuesday, adding that modern technology, including the near-ubiquitous use of smartphones and apps, allows patients to take more control of their care by virtue of gaining more access to their data.

Through the two proposed rules—724 pages from ONC and 250 from the CMS—regulators intend to push the industry to make use of application programming interfaces to speed up how patients can access information on their mobile devices.

"With APIs, you get your data into your platform, your tools, your display," Rucker said. "If you want to go to another provider, you can."

The proposals also spell out how regulators will fight data-blocking by payers, vendors and providers. The ONC rule lays out seven exemptions for withholding information, including preventing patient harm, promoting security of health information and responding to requests that aren't feasible.

HHS had already taken steps last year to punish hospitals and physicians financially for not sharing patient information.

"The idea that patient data belongs to providers or vendors is an epic misunderstanding. Patient data belongs to patients," CMS Administrator Seema Verma said to a round of applause during a speech Tuesday evening.

She called information-blocking "a thing of the past," suggesting that organizations that continue the practice will see fewer opportunities to participate in government-sponsored programs.

Former government officials praised the Trump administration's actions.

"We needed this rule as a call to action for the private sector," Mike Leavitt, who was HHS secretary under President George W. Bush, said during a panel discussion earlier in the day that included Verma.

Verma reinforced that notion during a news briefing with reporters, saying that the CMS is using its power as the nation's largest payer to prompt other parts of the industry to follow.

"The federal government invested $34 billion (in electronic health records) and look at where we are," Verma said. "The industry has not done the right thing," which has forced the government to step in.

She pointed out that more than 1,500 developers have been working on apps for the agency's Blue Button initiative, which Verma launched at HIMSS in 2018. That project allows beneficiaries to collect patient data, including claims information from insurers, on their mobile devices.

Aneesh Chopra, who served as chief technology officer under President Barack Obama, noted that the initial meaningful use regulations merely set a floor for what kind of and how information could be shared. The proposed regulations should serve as a catalyst to put more useful data in play.

Indeed, Karen Murphy, executive vice president and chief innovation officer at the Geisinger health system, equated electronic health records to electronic filing cabinets. Murphy, who acknowledged she hasn't read the rules yet, added that the inefficiency in today's digital environment leads to increased costs and inefficient care.

One area where the CMS and ONC won't yet be pushing the industry is on patient matching and ensuring the patients are linked to the correct record.

Congress has for decades limited HHS' ability to pursue a national patient identifier. Those restrictions have loosened during the past couple of years and the ONC in 2017 awarded $75,000 to six grantees to develop patient matching algorithms. In its proposed rule, the CMS asked for comments from the industry on how it can tackle patient matching.

"How can we put the weight of CMS behind patient identification and patient matching?" Verma asked during her speech.

For his part, Rucker said that technology is evolving quickly, suggesting that in a pro-consumer market, the industry will be forced to respond.

Verma also noted that the CMS is seeking information on how to start applying health IT standards to post-acute providers.