Two new final rules proposed by the Trump administration should serve as a warning to providers that the federal government “is serious” about ensuring patients and residents have access to their health data, according to industry experts.
“The one thing I would take away from all of this is: They are so serious. The federal government is very serious about opening up patient health information and making sure that information is being exchanged,” said Donna Doneski, director of policy and membership with the National Association for the Support of Long Term Care.
Promoting interoperability
The Department of Health and Human Services on Monday announced a newly proposed final rule issued by the Centers for Medicare & Medicaid Services that focuses on promoting interoperability and giving patients’ increased access to their health information and data.
Under the “Interoperability and Patient Access” final rule, CMS-regulated payers — including Medicare Advantage organizations, Medicaid fee-for-service programs and Medicaid managed care plans — would be required to implement and maintain an application programming interface (API) that allows patients to easily access their claims and encounter information through third-party applications.
They would be required to implement the patient access API starting in January 2021.
“Giving these types of patients access to their medical claims and encounter data is very important [and] very exciting, but for the patients in nursing facilities, you have to look at the structure that IT developers are kind of dealing with nursing homes,” Cynthia Morton, NASL’s executive vice president, told McKnight’s Long-Term Care News.
“It’s exciting, but it’s going to take a lot of pieces to come together and get that done by 2021,” she added.
Morton and Doneski both explained the final rule also proposes a new requirement of participation for Medicare- and Medicaid-participating hospitals to send electronic notification to another healthcare facility, community provider or practitioner when a patient is admitted, discharged or transferred.
They added NASL will continue to review the interoperability rules to determine “what extent are long-term care providers required to do all these things that maybe hospitals are required to do.”
Doneski also warned that the rule should help long-term care providers prepare for a time when their patients will begin asking for their health information.
“You’ll need to have an answer for that,” Doneski said.
Patient access and control
HHS also announced a final rule issued by the Office of the National Coordinator for Health Information Technology. The rule establishes secure, standards-based API requirements to support a patient’s access and control of their electronic health information.
“[The federal government’s] picture of success is [a] consumer being able to use an app on a smartphone to get their data on their nursing home stay or their data on their hospital stay,” Morton said.
“While that sounds like something that the government can just make happen, when it comes to the long-term care environment, I think that’s still elusive,” she added.
