The U.S. Department of Health and Human Services recently finalized two highly anticipated rules designed to give patients more control over their health care information by making it more accessible. Although mainly directed at payers and hospitals, the rules will impact physicians as well.
Individuals will have access to their health care information in a similar way to their finances, travel, and other components of their lives. The goal is to make it easier to exchange patients’ health care information between providers, payers and the patient.
While this effort began long before the COVID-19 pandemic, the increased use of telehealth during the pandemic, including through mobile apps, has acquainted patients with many of the benefits of managing their health care through technology. It has also made the need for true interoperability all the more urgent.
New rules are:
Public Reporting and Information Blocking (Applicable Late 2020) – Beginning in late 2020, health care providers will be required to affirmatively attest that they are not engaging in information blocking.
Digital Contact Information (Applicable Late 2020) – Also in the latter part of 2020, the Centers for Medicare and Medicaid Services (CMS) will begin publicly reporting the names and National Provider Identifiers of providers who do not have their digital contact information in the National Plan and Provider Enumeration System. CMS will engage in public education efforts on this initiative.
Admission, Discharge, and Transfer Event Notifications (Applicable Spring 2021) –Allergists who are identified as a patient’s primary care provider will begin receiving a patient’s admission, discharge, and/or transfer notification when a patient is discharged from a hospital or other facility. It is hoped that these notifications will improve transitions in care by allowing physicians to reach out to the patient and deliver appropriate follow-up care in a timely manner.
Plan Provider Directories – Beginning in July 2021, federal health care plans (e.g., Medicare Advantage, CHIP and Medicaid MCOs) must maintain accurate and up-to-date directories of their networks through an electronic and publicly available application programming interface (API). APIs are the technology that allow mobile apps to exchange data, talk to each other and other data sources.
Patient Access to Claims and Health Data – Also taking effect in July 2021 is a requirement that federal plans, as well as plans offered through certain exchanges, share with their enrollees claims and other health information – including clinical data and laboratory results – electronically.
These policies on interoperability, information blocking, and patient access to health data represent a significant effort by the administration to enable patients to make more informed healthcare decisions and more easily access their health care information.