Weighing the pros and cons of proposed interoperability rules
The CMS and the Office of the National Coordinator for Health Information Technology are now sifting through hundreds of comments voicing praise and criticism for companion interoperability and information-blocking rules released in February.
The public comment periods for the proposed rules, which outline how regulators will require insurers and providers to share medical data with patients, closed last week. Here’s a snapshot of what healthcare stakeholders thought of three key themes in the proposed rules:
Using application programming interfaces to bring data to patients
Pros:
Setting a common standard for APIs provides a foundation for providers and insurers to exchange data with one another and other companies, such as third-party apps
APIs have modernized numerous other industries, such as allowing airline websites to aggregate flight information and ride-sharing apps to access map services
Cons:
There’s no guarantee that third-party apps won’t misuse patient data, leading to concerns over privacy and security
Requiring payers to begin offering patients the ability to access data via APIs in 2020 is too early
Taking steps to prevent information-blocking
Pros:
Limiting fees that technology vendors are allowed to charge for data access is important, since price shouldn’t be a barrier for allowing patients to view their information
The seven exceptions the ONC proposed for when information-blocking is acceptable—such as if a provider is working to prevent patient harm—helps to maintain the physician-patient relationship
Cons:
If technology vendors aren’t able to charge fees for data access, it might discourage companies from offering more advanced services
The exceptions for when information-blocking is acceptable are too broad and will cause confusion, particularly given potential overlaps with existing regulations, such as HIPAA
Sharing price information
Pros:
Providing patients with information about how much they would be charged for various services has the opportunity to help drive down costs for consumers
Requiring providers to disclose this information could help to draw attention to which providers are most affordable and which are arguably driving higher costs
Cons:
Figuring out pricing information— which involves a patient’s insured status, in-network status and more—is complicated, and providers won’t be ready to present this data by the time the final rule goes into effect
The ONC may lack the authority to require providers to offer price information, as it arguably goes beyond congressional intent in the 21st Century Cures Act