Many senior healthcare executives lack familiarity with the federal government’s proposed rules designed to improve interoperability and patient access to data that were released earlier this year, according to a new report.
A centerpiece of the 21st Century Cures Act, which became law in 2016, are new regulations designed to help drive increased efficiency and transparency in healthcare through a variety of measures, including preventing information blocking and expanding how patients can access their healthcare information. Organizations that do not comply with the new regulations—which apply to essentially any organization handling patient medical records—could face substantial penalties, per two separate proposals released in February from CMS (the Centers for Medicare & Medicaid Services) and ONC (the Office of the National Coordinator for Health IT).
The proposals have several layers to them, with key elements related to application programming interface (API) standards, electronic health record (EHR) certification, and EHR vendor business practices and behaviors.
New research findings from Accenture, however, reveal that fewer than one in five (18 percent) of the executives surveyed in key leadership positions at U.S. healthcare companies said they are “very familiar” with the proposed regulations, while 17 percent said they either “know nothing” or “have never heard” about the Cures Act. Around 53 percent said they are “somewhat familiar,” with 12 percent “vaguely familiar.” Overall, nearly one in three (29 percent) of survey respondents lack familiarity over the proposals.
For the research, Accenture surveyed 76 chief information officers (CIOs), chief technology officers and vice presidents of information technology at U.S. healthcare providers and healthcare payers with more than $1 billion in annual revenue. Executives from providers comprised 57 of the interviews, and executives from payers comprised 19.
Healthcare payers, however, appear somewhat better informed and prepared for the new regulations than do healthcare providers. Specifically, 26 percent of payers surveyed said they are “very familiar” with the regulations, compared to 16 percent of providers. Similarly, 26 percent of payers believe their organization is “very prepared,” compared to only 5 percent of providers who share that view.
Overall, 40 percent of those polled believe the requirements will have little or no impact on the IT operations of their organization, and 30 percent see little impact on their organization’s ability to meet the needs of their patients and customers.
Recently, a group of prominent industry associations penned a letter to members of Congress, asking them to use their oversight authority to ensure that federal health officials improve certain elements of the rules. For instance, the groups believe that the rules need to do a better job of protecting patient data privacy and ensuring health IT security. What’s more, they believe that the information blocking components are too complex.
In that regard, in June, stakeholders similarly expressed major concerns with the government’s proposals, particularly as it relates to their vagueness, as well as timelines that some feel are far too aggressive. One group— Health Innovation Alliance (HIA)—went as far as to formally call on ONC specifically to rescind its regulation, noting that the information blocking exceptions to the proposed rule are so vague that "they will produce a market worse than today's status quo."
Indeed, in its proposed rule, ONC implements the information blocking provisions of the Cures Act, which defined information blocking as interfering with, preventing, or materially discouraging access, exchange, or use of electronic health information. Violators can be subjected up to a $1 million fine if they are found to be bad actors.
But as some stakeholders have attested, the proposed information blocking exceptions are “both complex and confusing.” One example of this is “significant confusion around the definition of ‘electronic health information’ or EHI, which forms the basis for much of the policies in the rule,” according to the recent letter from associations.
While the original timelines had the rules being finalized sometime later this year, it’s now expected that given the concerns detailed by stakeholders, the release of the final regulations will be pushed back.
“Our survey findings are a wake-up call for health organizations and agencies that remain relatively uninformed about the regulations, or who are not actively preparing. Complying with the regulations will provide them with a major opportunity to enhance the services they provide and to fundamentally improve consumer engagement in their healthcare,” said Andy Truscott, managing director and technology consulting lead in Accenture’s Health practice and a member of U.S. federal government advisory groups on health IT and Health Level Seven (HL7).
Phil Poley, Accenture managing director for public sector health, added, “Medicaid agencies, state health information exchanges, and state chief information officers will also be impacted by the new law. The new regulations will have major implications for public sector health entities, including Medicaid departments, state health information exchanges, and state chief information officers. These organizations will need to understand what the regulations mean for them in terms of technology requirements, processes and serving their customers, which include citizens and organizations alike. Given the timetable and requirements for compliance, they need to be in heavy preparation and planning mode now.”
