The U.S. Department of Health and Human Services (HHS) recently proposed a new rule to support seamless and secure access, exchange, and use of electronic health information (EHI).
The proposed rule significantly change the landscape for health plans. They also take a big, meaningful step forward in driving the industry towards real-time operations.
Since the passage of the 21st Century Cures Act in 2016, defining and understanding “Information Blocking” has been a central focus and concern. While the definition of Information Blocking is placed in the hands of the Office of the National Coordinator (ONC), the Center for Medicare and Medicaid Services (CMS) has been addressing the issue in a different way.
When you read the NPRM you find numerous references to both the Blue Button 2.0 API and the requirement for health plans to release settled claims information to their members within one business day. In patients on-going battle to get their hands on their health information, existing rules give organizations 30 days to respond.
We have to recognize that time is an information block. The changes proposed in the NPRM to reduce this lag to one business day is a big step forward. When this is coupled with promoting a standard Blue Button 2.0 API for consumer access, the proposed rule sets the groundwork for new types of Health Information Exchange where the patient, or their designated application, service or organization coordinate the movement of information to wherever the patient needs it.
The proposed rule also takes steps to have health plans forward a member’s health history when the member moves to a new health plan. This is another important promotion of consumer-controlled data liquidity.
Taken together, the requirements in the NPRM are a big step forward to achieving real –rather than token–patient access to their health information.
Mark Scrimshire is the Entrepreneur-In-Residence at NewWave Telecoms and Technologies where he supports the Centers for Medicare and Medicaid Services (CMS) as their Blue Button Innovator and Developer Evangelist . Mark has been responsible for conceptualizing, designing and implementing the CMS Blue Button 2.0 API that brings Consumer-Directed Exchange, OAuth2.0 and FHIR together to enable 53M Medicare Beneficiaries to share their claims history with applications of their choosing. Mark, is a lifelong technologist with more than 20 years experience in the health care field. He is also Chief Instigator for the HealthCa.mp un-conference series and CTO and Co-Founder of Medyear.
Date: March 20, 2019