The federal Health Information Technology Advisory Committee tackled a spate of adjustments to the Office of the National Coordinator for Health IT's proposed interoperability rule during a meeting Monday, but postponed a vote on a task force's recommendations related to fees.
HITAC, established under the 21st Century Cures Act, meets monthly to provide policy recommendations to the ONC. The primary topic in discussion at the May meeting concerned information-blocking, with HITAC's information-blocking task force presenting roughly 50 recommendations.
HITAC voted to pass recommendations related to the maintaining privacy and security of electronic health information, as well as setting standards for how long an organization has to respond to information requests. One of the more contentious recommendations that passed involved when providers and vendors will need to update their contracts after the rule takes effect.
Companies will have five years instead of two years now, and vendors should propose the plan for the updates after two years. They should update the contracts at the next renewal date or within five years.
The change would decrease the burden on providers and vendors as they renegotiate contracts. "Picking up every single contract that people have right now and subjecting them to loyal scrutiny could be quite a heavy lift," said Andrew Truscott, the task force's co-chair and Accenture's managing director for health and public service.
The change goes hand-in-hand with a previous recommendation HITAC approved, which established that contractual obligations that are in conflict with the regulations requirements become void once the rule goes into effect, he added.
After a nearly hourlong discussion on the information-blocking task force's recommendations regarding fee structures, HITAC tabled a vote on the measures. The recommendations will be revisited later this month.
As written, the proposed rule aims to curb vendors' ability to charge fees for access to certain data.
"We fully understand that the intent of the drafting was to address problematic pricing behavior," Truscott said. However, he said the task force is concerned regulations outlined under the current rule would raise costs overall as a result of compliance activities, as well as "putting nearly all interoperability products and services under federal price controls."
The task force recommended the ONC distinguish between "basic access" to data about a patient, for which vendors would be allowed to charge fees to recover expenses, but not to gain profit. For data that goes beyond basic access, which the task force referred to as "value-added access," vendors would face fewer restrictions on fees.
Some HITAC members expressed concern that patients should still be able to easily access value-added capabilities such as risk-scoring algorithms without cost barriers. Other members noted regulations regarding fees might inadvertently discourage vendors from innovating.
"I'm all for getting all this access," said Dr. Kensaku Kawamoto, associate chief medical information officer at University of Utah Health. "I'm afraid that from the EHR vendor and other vendors' perspectives, they're going to become incented to do nothing else than what's minimally required."
HITAC also tabled discussion on defining relevant statutory terms and provisions, as well as a recommendation on sharing screenshots of a vendor's software. The committee scheduled a follow-up meeting for May 22 to discuss the tabled recommendations.
