CMS and ONC Issue Final Rules On Patient Health Data- Now What?

Pam Roman

Two agencies have issued their final rules on sharing patient health data, and although we expected them, the rules leave most healthcare payers and providers wondering what to do.

The Centers for Medicare & Medicaid Services (CMS) outlines a series of policies on health information sharing and access in its Interoperability and Patient Access final rule (CMS-9115-F). Some of the policies become applicable as early as fall of this year, with one major policy – “Patient Access API” – coming into force January 1, 2021.

The Office of the National Coordinator for Health Information Technology (ONC) issued its final rule under the 21st Century Cures Act. ONC also promotes patient access, with a goal of “… an ‘app economy’ that provides innovation and choice to patients, physicians, hospitals, payers, and employers.”

Both the CMS and ONC rules adopt HL7/FHIR® standards. HL7s Fast Healthcare Interoperability Resources (FHIR for short) is simply a data API standards framework that lets us share data using simple web standards and build solutions that interoperate. FHIR lets us easily aggregate data from disparate systems to gain new insights using machine learning.

“The CMS rule stresses patient access to their own electronic health data from payers,” said Tim Henrion, Prolifics’ Quick FHIR Solution Director. “ONC is mostly concerned with interoperability and preventing ‘information blocking’ – real or perceived practices that an organization might use to keep information from patients. The goal of both CMS and ONC is to give patients the information they need to make decisions and shop in the healthcare marketplace – and ultimately drive down costs.”

Join Tim Henrion and other members of the Prolifics team for an educational presentation about CMS and participate in an open dialogue with others in your industry. The virtual event is happening at 4:30 p.m. ET, on Tuesday, April 22. Be a part of the conversation and stay informed.