The burdens caused by electronic health records (EHRs) and the difficulties created by information blocking are two issues the Office of the National Coordinator for Health Information Technology (ONC) wants to help with, according to Andrew Gettinger, MD, ONC chief clinical officer. At AHIMA’s Advocacy Summit on Monday, Gettinger discussed how ONC has been making progress on these topics with a report and a Notice of Proposed Rulemaking (NPRM).
In November 2018, the Department of Health and Human Services (HHS) released a draft report, “Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs,” for public comment. This work, led by ONC in partnership with the Centers for Medicare and Medicaid Services, was required by Congress under the 21st Century Cures Act.
Comments closed in January, and Gettinger said more than 200 comments were received. The next step, he explained, is a final report scheduled for completion this spring or summer. In addition to comments, ONC has convened listening sessions, town halls, and webinars, and incorporated other public comments from different rules. The final report will not take the shape of a rule, Gettinger said, but it represents a way of getting suggestions from the stakeholder community as to what the federal government can do to reduce burden—not by laws, but by regulation.
Gettinger said the chief burdens reported by stakeholders are billing-related documentation, prior authorization, quality measurement, poor user experience with health IT, too much time outside of patient care spent on electronic records, and prescription drug monitoring programs poorly integrated into EHRs.
“We are committed, along with NCVHS, to really push hard to see what we can do about prior authorization,” Gettinger said. “We are not waiting for this report to be finished; we’re going to start taking action.”
In February, ONC published a Notice of Proposed Rulemaking to Improve the Interoperability of Health Information. The proposed rule, also required by the 21st Century Cures Act, deals with information blocking and patient access, among other things.
Gettinger said that Congress has heard that healthcare has not realized all of the benefits of the billions of dollars spent in digitizing healthcare, in that information is not moving easily or effortlessly. “The presumption is information will flow,” Gettinger said. The intent of the rule is that the government expects electronic health information to move seamlessly and effortlessly, and that patients and providers have full access to information, he said.
“I suspect that, in particular, this group will have a lot of opinions about our proposed rulemaking,” Gettinger told the audience. “I will be very enthusiastic about hearing them. They won’t count unless you formally submit them in the Federal Register.” The agency is required to read comments and respond to them, he added. “I know there are things in the rule that are right in your wheelhouse, please take the time to comment.” Comments on the NPRM are open until May 3.