ONC: Information Blocking Opens Doors for Interoperability

Healthcare organizations and stakeholders must move on from a compliance mindset and begin to focus on the vast information blocking opportunities at hand, according to Micky Tripathi, national coordinator for health IT.

“We recognize information blocking is a law because it has civil monetary penalties associated with it,” Tripathi said during the Workgroup for Electronic Data Interchange (WEDI) information blocking event. “It's got to be thought of as a compliance mindset.”

However, Tripathi wants compliance to be the floor, not the ceiling, of healthcare stakeholder thoughts and ideas.

On Wednesday, Tripathi headlined WEDI’s “Ready, Set, Comply! Meeting the Information Blocking Challenge” to take a deep dive into the 21st Century Cures Act’s information blocking provisions.

The information blocking provisions officially published on April 5, 2021, and providers, health information exchanges, and health IT developers will now be held accountable to abide by the regulations.

“What do we do beyond that?” Tripathi posited during his speech. “How does that help us move the industry? How does this help us rethink the way we thought about information sharing and stakeholder access to information across various parties?”

Tripathi said his job as ONC leader is to help the healthcare industry move beyond initial questions, such as defining the information blocking law or setting up a compliance framework. He wants to assist stakeholders in focusing on specific strategic opportunities and how those opportunities might change the way a healthcare organization is doing business and present real opportunities for greater value from both a clinical and financial perspective in the future.

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

Patients will gain access to their health information and can shop for and coordinate their healthcare using their respective smartphones.

“We're doing everything we can to try to evangelize and encourage the industry to implement in advance of that date,” Tripathi said. “That's already happening, which is great.”

However, a significant challenge of having a very fragmented healthcare industry is some vendors will get ahead and take on the challenge, while some will fall behind, the ONC leader explained.

“That's always the challenge for developing interoperability and developing an app-based world where you'd ideally like to be able to have solutions that migrate across or be implemented across systems without having to do too much system customization,” Tripathi said.

“Without the floor of regulation in a fragmented healthcare industry, you're always going to have a lot of variation around what's the floor mat. We recognize that's the important role that regulation plays in health care.”

As Tripathi noted in a separate interview, the April 5 date is limited to structured data under the US Core Data for Interoperability (USCDI), allowing healthcare organizations to work with a limited set of patient data. However, he wants healthcare organizations to be fully prepared for 18 months from now when all structured data and most unstructured data will be available.

“What are we going to start doing with notes?” Tripathi posed. “How are those valued? What technologies do we want to apply there?”

“Once the gates open to the full dataset, there'll be a lot more unstructured data available,” Tripathi said. “We should start thinking about as an industry and how we're going to start to use that information in meaningful ways.”

To prepare for October 2022, Tripathi recommended healthcare organizations to make all patient data available as if the complete dataset was open over those 18 months.

“There’s a number of ways to think about that opportunity,” Tripathi concluded. “We have to move on from a compliance mindset to an opportunity mindset. We have to take compliance into account, but there are especially rich areas that have yet to be explored.”