Healthcare Organizations Ask for Delay on Information Blocking

Sept. 28, 2022
Ten provider organizations seek another year to comply as well as corrective action warnings before penalties are imposed

Ten healthcare membership organizations, including CHIME, MGMA and the American Hospital Association, have asked the Department of Health & Human Services to delay the Oct. 6 information blocking deadline by a year.

As detailed in the 21st Century Cures Act, healthcare providers, health IT developers, health information exchanges (HIEs), and health information networks (HINs) are prohibited from engaging in “information blocking” practices starting Oct. 6. They must be able to share all electronic protected health information (ePHI) in a designated record set, as defined under HIPAA.

The organizations said that despite their best efforts to educate their members, “significant knowledge gaps and confusion still exist within the provider and vendor communities with respect to implementation and enforcement of information blocking regulations. Based upon feedback from our members that continues to build, it is evident that both healthcare providers, clinicians and vendors are not fully prepared for the October 6 deadline.

The Sept. 26 letter to HHS Secretary Xavier Becerra said stakeholders are confused by an Office of the National Coordinator’s EHI infographic. “Since providers and other actors will be held accountable for EHI interoperability, consistency in EHI interpretation is critical. Moreover, significant confusion continues to exist on how the eight information blocking exceptions are applied when EHI cannot or should not be exchanged,” the letter said.

The organizations go on to request that in addition to considering postponing the information blocking compliance deadlines, HHS use corrective action warning communications to providers/clinicians prior to imposing any monetary disincentives or beginning a formal investigation.

Other organizations signing onto the letter are America’s Essential Hospitals, American Academy of Family Physicians, American Health Care Association, American Medical Association, Association of American Medical Colleges, Federation of American Hospitals, Medical Group Management Association, and the National Association for the Support of Long Term Care (NASL).

“CHIME members remain steadfast in their dedication to be a trusted partner for patients and safeguard their ability to access their healthcare records, but it’s clear that more time is needed to ensure that providers have a thorough understanding of these important policies,” said Russ Branzell, president and CEO of CHIME, in a statement. “There has not been enough guidance on best practices and potential enforcement.” Overwhelming feedback from CHIME members, representing a broad range of providers from across the healthcare continuum – including their electronic health record (EHR) vendors, indicates that they are not fully prepared for the Oct. 6 deadline.”

Others in the health IT field are not interested in a delay. Troy Bannister is the CEO and co-founder of Particle Health, which describes itself as creating a user-friendly API platform for advanced healthcare data exchange. “I founded Particle Health five years ago around the mission of dramatically changing lives by enabling simple and secure access to actionable healthcare data,” he wrote in a blog post. “At the time, the 21st Century Cures Act was already two years old — and we trusted the government to turn that Act into enforceable law. Now, six years after the original signing of the legislation, patient access to data is still not a reality to Americans,” he wrote.

“I got a bit of déjà vu this week reading about how providers are coming together to try and push back the October 6, 2022 enforcement date. This time by a whole additional year. This same exact group (and others) came together and published a different letter right before Anti-Information Blocking was turned into law back in 2020 and around the beginning of the pandemic. Imagine if the rule was already enforceable during the onset of COVID-19? Armed with the right data access Particle and other connected health IT vendors would have been able to stand up elevated contract tracing efforts, vaccine registration and a whole lot more… but we couldn’t make it happen because a small group of people pushed back.”

“It has always been my hypothesis that the lack of access to clinical data at scale, is the core problem that can be directly linked to most of our US healthcare system’s inefficiencies today,” Bannister wrote. “These issues have a fundamental impact on healthcare costs but also quality of care and ultimately, patient outcomes. This is precisely why we can’t keep waiting for organizations to spend an entire decade to continue preparing. There is simply too much at stake. The rules are written. The policies are set. The technology is standardized. We’re ready to turn this on and empower individuals to easily access their medical information when and where they need it most – and yet the powers that be successfully continue to push their way out.  It’s time we get this over the line.”

Meanwhile, the Sequoia Project has released a set of resources designed to help regulated entities better comply with the information blocking requirements. The resources include:

• Good practices for information sharing and information blocking compliance
• A further exploration of the expanded definition of electronic health information (EHI) and related considerations
• An infographic depicting the web of information systems included in the expanded definition of EHI
• Operational implications of the move to an expanded definition
• Policy considerations

These documents were developed by the Sequoia Project’s Information Blocking Compliance Workgroup (IBWG), which is supported by the Sequoia Project’s Interoperability Matters initiative. The Sequoia Project sought feedback from the public on the draft versions of these resources last month, and after carefully reviewing the comments received, the IBWG released the final versions.

“The Sequoia Project is grateful to the public for taking the time to provide feedback on these documents, as well as to the members of the IBWG and our subject matter experts whose collaboration and dedication was integral to the development of these resources,” said Mariann Yeager, chief executive officer of the Sequoia Project, in a statement. “We look forward to continuing to work to advance interoperability and build a community of practice around this critical topic.”

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