In advance of the expected release of the Office of the National Coordinator for Health Information Technology’s (ONC) final information blocking rule—The Sequoia Project, an organization that was recently named the ONC TEFCA Recognized Coordinating Entity (RCE) —has released an information blocking guidance to the health IT community.
The guidance was developed by a multi-stakeholder information blocking workgroup created to:
- inform Sequoia Project’s comments to ONC on the proposed rules
- identify practical implications of the proposed and final information blocking rules
- build a community of practice around collaborative implementation before and after the ONC final rule
The information blocking workgroup was created out of Sequoia Project’s Interoperability Matters initiative, which is a public-private cooperative formed in 2018 focused on bringing together various stakeholders to identify and work on tough interoperability challenges.
ONC’s interoperability proposed rule, set to be finalized day now, has key elements in it that represent great significance for health IT stakeholders, who will now be more under the microscope than ever before as it relates to their efforts in making sure that health information is seamlessly moving—while not restricting such efforts. The rule has a substantial section devoted to information blocking with potentially hefty fines for violators.
A previous phase 1 deliverable of the workgroup was provided to the ONC in May 2019 as formal comments on ONC’s proposed rule. Now, this latest guidance is the phase 2 deliverable, focused on implementation and implications of the ONC’s proposed rules and potential outcomes. During phase 3, which began in January 2020, the workgroup will review the final rule and identify and address priority implementation topics and approaches.
The workgroup consists of an array of health IT stakeholders, including representatives from industry associations, consumer organizations, federal agencies, health information networks, public health facilities, technology vendors, providers, payers, and more.
The workgroup addressed implementation-related aspects of priority components of the information blocking regulation, including:
- regulatory definitions (e.g., health information exchange and health information network)
- information blocking practices
- recovering costs/licensing exceptions
- compliance plans and implementation plans
Previously, industry observers have contended that the proposed information blocking exceptions—of which there are seven—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 a group of leading industry associations—including the American Medical Association (AMA), the College of Healthcare Information Management Executives (CHIME) and others— who penned a letter to members of Congress back in September.
“Given the broad and significant impact the rules would have to the health information sharing community, we formed the Information Blocking Workgroup. Working collaboratively to interpret and apply the rules will be important to fostering cooperation as the community prepares for ONC and OIG (Office of Inspector General) enforcement,” said Mariann Yeager, CEO of The Sequoia Project.
She added, “This report aims to be a guide for the community. Implementation guidance is essential to reduce uncertainty and prepare for compliance.”
The Sequoia Project originated in 2012 to advance healthcare interoperability, and is an organization that has managed the eHealth Exchange, which has become the largest health information network in the U.S. It also has supported the Carequality initiative.
In September, the nonprofit Sequoia Project was awarded a cooperative agreement to serve as the Recognized Coordinating Entity (RCE) that will manage and oversee Qualified Health Information Networks (QHINs) under ONC’s Trusted Exchange Framework and Common Agreement (TEFCA)—the government’s plan to advance trusted exchange of electronic health information among health information networks.