Ambiguous Information Blocking Regulations Worry Providers

Many providers feel prepared for the Office of the National Coordinator for Health IT (ONC) 21st Century Cures Act’s information blocking provisions. However, according to a recent KLAS Research Performance Report, the rule’s vagueness is still causing general unease across the industry.

Going into effect on April 5, the rules hold providers, health information exchanges, and health IT developers accountable for abiding by the regulations. But before the launch, KLAS surveyed over 40 providers to gauge preparedness, top challenges, and how the rules would impact interoperability.

Seventy-one percent of respondents said their organization’s level of preparedness for the regulations was either prepared or very prepared. Additionally, most reported ample time to prepare for April 5.

Due to increased health IT and legal resources, 91 percent of respondents from major health systems, defined as systems with over ten hospitals, said they were prepared or very prepared. But 12 percent of respondents did not feel ready, and 17 percent were uncertain.

Unprepared healthcare organizations were still trying to understand the requirements and had not given much thought to the change.

“This is due primarily to the rule’s vagueness, which is proving to be a bigger roadblock than actually implementing updated protocols and technology,” KLAS explained. “Even respondents who feel prepared acknowledge that the lack of clarity could create unanticipated challenges downstream. Several respondents also say it has been difficult to get their HIT vendors to address rules in a timely fashion.”

The majority of respondents said they feel confident that their EHR system will meet new technical requirements. Although most EHR information blocking requirements do not launch until October 22, most respondents are optimistic their vendor will be ready.

Most EHR vendors had at least one client report doubt about preparedness. Clients with doubts said it took too long to bring necessary functionality live, KLAS wrote. In the meantime, respondents had to develop workarounds.

Healthcare organizations expressed confidence in Epic, Meditech, NextGen Healthcare, and Cerner integration abilities compared to other EHR vendors.

Respondents are split about whether the information blocking rules will enhance interoperability. Even some of the healthcare organizations that expressed confidence in their health IT or EHR vendor preparation do not feel confident that the interoperability rules will mitigate interoperability barriers, KLAS wrote.

“Some who are uncertain say too many exceptions exist for the changes to be effective; others say the current requirements are too focused on reducing barriers to patient access and therefore won’t resolve technical barriers between vendors, which they see as the true hindrance to interoperability; yet others express concern about potential negative repercussions of patients having access to all provider notes,” explained KLAS.

“Those who think the changes will accelerate interoperability point to the fact that those who aren’t in compliance risk being fined. They also cite confidence that the technology will mature as vendors are required to share.”

Forty-five percent of respondents hired health IT vendors for additional help, while only 2 percent hired outside service firms. Most respondents reported having sufficient health IT, clinical, and legal resources within the healthcare organization to identify specific protocols to ensure patient data access.

“In fact, when respondents were asked what HIT vendors or solutions outside of their EMR played an important role in their preparation efforts, the most common response was that in order to get the right data where it needed to be, organizations replaced third-party solutions with additional modules from their enterprise EMR vendor,” wrote KLAS. “The next most commonly mentioned solutions are HIEs and other services that improve sharing with outside entities.”

At its launch, Micky Tripathi, national coordinator for health information technology, and Steven Posnack, deputy national coordinator for health information technology, asked healthcare stakeholders for input regarding information blocking and coinciding enforcement efforts. Furthermore, ONC said it would continue to release information blocking educational materials to help keep stakeholders informed.  

Looking forward, the 2015 edition health IT certification criteria updates and the new standardized application programming interface (API) functionality dates will be required by December 31, 2022.