21st Century Cures Act

See the following -

HHS Releases Interoperability Rules

Press Release | HHS | February 11, 2019

The U.S. Department of Health and Human Services (HHS) today proposed new rules to support seamless and secure access, exchange, and use of electronic health information. The rules, issued by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), would increase choice and competition while fostering innovation that promotes patient access to and control over their health information. The proposed ONC rule would require that patient electronic access to this electronic health information (EHI) be made available at no cost.

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HHS Releases Landmark Report: Reforming America's Healthcare System

On December 3, 2018, the Department of Health and Human Services (HHS) released an extensive, 120-page report on the administration's proposals to reform the healthcare system. The report, titled Reforming America's Healthcare System Through Choice and Competition, is divided into four major sections. The report that government policy of the last few years has suppressed competition, increased prices for healthcare, and limited choices for consumers. Though rich in detail as it tries to prove each of these points, the more than fifty recommendations are often broad and aspirational rather than practical. Since I am not a health economist, I will leave the market issues to others to discuss (many of the ideas in this report have been vetted and discussed by others previously). But there are two sections of the report which make direct mention of Health IT.

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HITAC Task Force Comments on ONC HTI-1 NPRM

 

On June 15, 2023, the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Proposed Rule Task Force 2023 released its recommendations on the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Proposed Rule which proposes new  provisions from the 21st Century Cures Act and makes updates to the ONC Health IT Certification Program (Certification Program). The limited-engagement task force met intensely during April, May, and June 2023 to develop its own set of observations and recommendations which were submitted to the Office of the National Coordinator for Health Information Technology (ONC).

Is The 1.5+ Trillion Dollar HITECH Act a Failure?

Hopefully, the public statements made by President Obama and Vice President Biden will lead to a public debate over the monumental problems that the HITECH Act and proprietary EHR vendors have caused the American people. While the press continues to report the figure of $35 billion as the cost of implementing EHRs, that figure does not tell the entire story. Perhaps the next step is to provide accountability and transparency. That would start with firm numbers regarding the real costs of EHR implementations forced on an unprepared healthcare system by the HITECH Act.

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Major Interoperability Initiative Launched During the Annual Meeting of The Sequoia Project

On December 5, 2019, HLN Consulting, LLC participated in The Sequoia Project's day long annual meeting which was held just outside of Washington, D.C. at the Gaylord National Resort & Convention Center. As a leading healthcare informatics consulting company HLN monitors developments in healthcare interoperability nationally with particular emphasis on the impact to public health agencies and their stakeholders. This conference represented a good opportunity to participate in the start of a major interoperability initiative that will play out over the next several years. In addition to this report, the Sequoia Project posted the proceedings of the meeting online, including the recorded discussions as well as the slides from the presentations. Read More »

MedStar Research Team Links Electronic Health Record (EHR) Usability Issues to Potential Patient Harm

Press Release | Medstar Health | March 27, 2018

Specific types of electronic health record (EHR) usability issues are associated with a variety of potentially serious patient harm events, according to a study released by MedStar Health researchers with the National Center for Human Factors in Healthcare. This study, which was published today by the Journal of the American Medical Association, is the first one of its kind to reach this conclusion, and it underscores the need for more and better collaboration among EHR vendors, providers and health systems, and other stakeholders, as well as a reexamination of federal policies for improved usability.

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Microsoft, Amazon, Google, IBM, Oracle, and Salesforce Issue Joint Statement Making Commitment to Open Source Healthcare Interoperability

Josh Mandel | Microsoft Industry Blog | August 13, 2018

Interoperability is an overlapping set of technical and policy challenges, from data access to common data models to information exchange to workflow integration – and these challenges often pose a barrier to healthcare innovation. Microsoft has been engaged for many years on developing best practices for interoperability across industries. Today, as health IT community leaders get together at the CMS Blue Button 2.0 Developer Conference here in Washington, DC, we’re pleased to announce that Microsoft has joined with Amazon, Google, IBM, Oracle, and Salesforce in support of healthcare interoperability...

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New Study Shows Patients Prefer Immediate Access to Test Results and have Unmet Information Needs

A recent study of 8,000 patients that accessed their test results via an online patient portal found that more than 95% wanted to continue to immediately receive test results through their portal. That percentage stayed at 95% when focused on patients with non-normal results. These findings come amid concerns that the immediate release of test results could lead to patient distress when patients access test results before their physicians could contact them and help to interpret those results...since the ONC information blocking regulations became applicable to health care providers on April 5, 2021, a patient may be able to access test results in parallel to those results’ availability to the ordering clinician.

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Obama and Biden Blast EHR Vendors for Data Blocking

As they are winding their terms in office, President Barack Obama and Vice President Joe Biden dropped a stink bomb on the health IT industry. Speaking at different events on Friday, January 9th, the President and Vice President both criticized proprietary electronic health record (EHR) vendors as the primary obstacle to the success of their administration’s health care strategy. This is the highest level acknowledgment so far of the serious impact that “lock-in” EHR software vendors are having on America’s medical infrastructure and the ability of physicians to provide medical care.

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ONC EHR Reporting Program RFI: A Public Health Perspective

On August 24, 2018, the Office of the National Coordinator for Health Information Technology (ONC) released a Request for Information (RFI) related to the EHR Reporting Program. This RFI is required by the 21st Century Cures Act and its primary purpose is to gather ideas and suggestions related to how ONC might provide better information about Certified EHR Technology (CEHRT). Apparently, the initial intention was to create a "star rating" like the type used in Consumer Reports to use to rate EHRs, but that seems to have been abandoned in favor of some kind of measurement system. But it is far from clear exactly how this would be done.

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ONC Finally Releases TEFCA—What it Might Mean to Public Health

On January 18, 2022 the Office of the National Coordinator for Health Information Technology (ONC) finally released version 1 of the Trusted Exchange Framework,  Common Agreement and the QHIN (Qualified Health Information Network) Technical Framework (QTF). Several years in the making, these documents represent the latest attempt at initiating a national health information exchange in the United States. This project is being managed by ONC’s Recognized Coordinating Entity (RCE), The Sequoia Project, and was inspired by both the HITECH Act and 21st Century Cures Act.

ONC Head Dr. Donald Rucker Addresses open API's, Interoperability and Usability During WEDI Keynote

Press Release | Workgroup for Electronic Data Interchange (WEDI) | August 23, 2017

Earlier this month, the Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange and a trusted advisor to the U.S. Department of Health and Human Services (HHS), held its 2017 Summer Forum which featured keynote addresses by Donald W. Rucker, MD, head of the Office of the National Coordinator for Health Information Technology (ONC/HHS) and Madhu Annadata, director, Division of National Standards, Centers for Medicare & Medicaid Services (CMS)...

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ONC HTI-1 NPRM Through Public Health Eyes

On April 18, 2023, the Office of the National Coordinator for Health Information Technology (ONC) published for comment the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Proposed Rule which proposes new  provisions from the 21st Century Cures Act and makes updates to the ONC Health IT Certification Program (Certification Program). Weighing in at over 500 pages (the pre-release version), this proposed rule provides some refinements to existing ONC programs, corrections to others, and extensions to yet other provisions. ONC provides additional materials about this proposed rule, including fact sheets, blog posts, and records from topical webinars on their website. Note especially the information provided about a joint ONC-CDC sponsored informational webinar which took place on May 24, 2023, and is available for playback on the site.

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ONC Interoperability Meeting Raises More Questions Than Answers

Adrian Gropper | The Health Care Blog | July 25, 2017

ONC’s first public event under the new administration was very well organized and run. Eight leading health information exchange incumbents were able to describe their current approaches and plans, the patient advocate position was clearly stated, and a nice synthesis of the issues raised by the trusted framework approach to interoperability was prepared by a consulting organization. Much to ONC’s credit, they went out of their way to provide access and public comment to an extent that is unprecedented in my experience. Slides and recordings will be posted soon and a 30-day comment period runs through August 24. Kudos to ONC...

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ONC Releases 2018 HITECH Report

In early January the Office of the National Coordinator for Health Information Technology (ONC) issued its annual report to Congress for 2018 on the adoption of electronic health records (EHR) and interoperability. This report is required under the HITECH Act and is further informed by requirements of the later 21st Century Cures Act...One thing that I think is notable was a short discussion about barriers to interoperability that we have heard before. The report identifies three types: technical barriers, financial barriers, and trust barriers. Within trust barriers the report mentions legal incentives to keep data from moving (I guess that would have better been phrased as legal disincentives to sharing), but this misses the point: It is the patchwork of inconsistent and incompatible State and local laws and regulations - not intentional information blocking - that presents a bigger challenge and barrier.

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