Regulations and guidelines for sharing data between providers, payers and public health are coming down the pike, policymakers said at the Healthcare Information and Management Systems Society trade show this week.
Here are three details policymakers shared at the conference.
1. Penalties for providers who violate information-blocking regulations. Long-awaited data-sharing regulations from the Health and Human Services Department's Office of the National Coordinator for Health Information Technology went into effect last year, but the federal government is still establishing penalties for those who violate the rule.
HHS' Office of Inspector General in 2020 proposed a rule for how it would impose financial penalties on health information exchanges and software developers that violate the regulations, which is expected to be finalized later this month. But, under the 21st Century Cures Act, the HHS secretary was directed to establish disincentives for providers.
HHS has yet to outline how it plans to penalize providers who violate the rule, but Secretary Xavier Becerra during a session at HIMSS22 said the department will do so this year. He cited an ONC analysis that found 77% of complaints to the agency about alleged rule violations have been against providers. Most of the complaints were filed by patients.
"Closing this enforcement gap is an HHS priority," Becerra said. "We will have more to share with you later this year."
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2. Payer-to-payer data-sharing regulations will build on FHIR. The Centers for Medicare and Medicaid Services in September delayed enforcement of a companion interoperability rule provision that would govern how payers are expected to exchange data with one another. The provision was expected to go into effect last January.
The provision is meant to allow patients to transfer their data when they switch health plans, said CMS Administrator Chiquita Brooks-Lasure during a HIMSS22 session. But CMS didn't set technical specifications for exchanging that data, which payers said would make it complicated to implement.
"The policy that CMS finalized did not quite hit the mark," Brooks-Lasure said. "It left too many open questions about how data should be exchanged."
CMS is working on a new rule to address those challenges and is looking at ways to incorporate the use of standard application programming interfaces, she said. CMS and ONC both require organization to use APIs that align with the Fast Healthcare Interoperability Resources format, a popular data-sharing standard, in other areas of their respective data-sharing rules.
Brooks-Lasure said CMS will share the new rule "soon."
3. Bringing public health agencies into health information networks. The Trusted Exchange Framework and Common Agreement, better known as TEFCA, is one of the core avenues the healthcare industry could lean on to exchange data with federal and local public health agencies more easily, said Micky Tripathi, who leads ONC, during a HIMSS22 session.
TEFCA—which sets standards and aims to create a network for state, regional and national health information networks to share data with one another—launched in January, initially with requirements related to exchanging treatment data and data requested by patients. Tripathi said he expects to see networks onboarded to TEFCA by the end of the year.
Next steps involve developing operating procedures for how participants should exchange data on payment, healthcare operations, government benefits determinations and public health.
ONC and the Sequoia Project, the private sector partner tasked with implementing TEFCA, are working with public health stakeholders like the Centers for Disease Control and Prevention to develop policy and technical requirements, as well as implementation guides, for public health uses for TEFCA, after which participating networks will be required to perform such data exchange.
