EHR Association

so, we hope to focus the power of health IT on achieving the common goal of a better, safer, and more accessible healthcare ecosystem that is centered on the patient and benefits all stakeholders. An Evolving Health IT Landscape Two driving forces are shaping today’s health IT landscape: the landmark 21st Century Cures Act, passed in 2016, and the global COVID-19 pandemic that changed both the face and trajectory of healthcare and health IT, particularly in the public health space. In March 2020, the Office of the National Coordinator for Health IT (ONC) published final rules implementing important Cures Act provisions related to advancing nationwide interoperability. The rules include requirements for developers of certified health IT to establish secure, standards-based application programming interfaces (APIs) to support patients’ access to information in their EHRs, and a prohibition on activities that interfere with the access, exchange, and use of electronic health information (EHI) by patients and other authorized stakeholders. That same month, the World Health Organization declared the COVID-19 outbreak a global pandemic. The U.S. response pushed healthcare providers to accelerate adoption of digital health, particularly telehealth, and laid bare the weaknesses created by the industry’s limited interoperability, outmoded public health infrastructure, and disparities in care. For the EHRA– the voice of companies developing, marketing and supporting EHR systems – how health IT developers embrace the challenges and opportunities created by these forces for change will have a lasting impact on patients, providers and the nation’s ability to provide safe, effective and equitable care. EHRA The Information Blocking Dilemma Ensuring patients and their providers have easy, secure access to their EHI as mandated in the Cures Act has long been an identified priority of the EHRA and its member organizations. Nonetheless, we have identified several challenges with the Act’s information blocking requirements. Notably, because the information blocking provisions are both novel and expansive in their approach to regulating the use of health IT and the exchange of data, it is difficult for the impacted actors (healthcare providers, health information exchanges/health information networks, and developers of certified EHR technology) to fully understand what is expected or needed to comply with its requirements to avoid inadvertently being considered an information blocker. They are both broad enough for us to know compliance requires adjustments to a range of standard business practices – along with considerable documentation and the expenditure of significant resources – yet too vague to understand what specific changes will help us demonstrate our ongoing commitment to information sharing. The regulation’s broad impacts and complexity have led to confusion on the part of actors, patients, and other stakeholders as to what actually constitutes “information blocking,” what the regulators consider good information sharing, and in which situations regulated entities have the discretion to protect EHI. Understanding the enforcement model that the Office of the Inspector General (OIG) is tasked to establish, but has not yet published, is critical to addressing many of the remaining uncertainties. To resolve these challenges and promote a common understanding of information sharing best practices without stifling innovation or penalizing innocent mistakes, the EHRA shared