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Doctor and nurse reviewing patient data

by John Travis
Published on June 24, 2019

Estimated read time: 4 minutes

Key Takeaways

  • Cerner endorses the Office of the National Coordinator for Health Information Technology’s (ONC) efforts to promote health care interoperability, prevent health care information blocking and update the health care information technology (HIT) certification program.
  • Cerner submitted public comment on the ONC proposed rule to affirm the proposals we support and our recommendations for improvement.
  • Cerner urges a careful, clear and practical approach from the ONC as it puts the 21st Century Cures Act’s information blocking provisions into action.

Earlier this year, ONC delivered its highly anticipated proposed rule on provisions of the Cures Act that support interoperability of electronic health information for patients, providers and others. In addition to a focus on HIT certification and interoperability in health care, the rule promotes the end of information blocking — a practice in which the access, exchange or use of electronic health information is restricted inappropriately.

Members of the HIT industry provided strong reactions to the rule. Cerner submitted public comment on the provisions that reflected our role as a HIT developer and client partner, as well as an advocate for our clients’ clinical missions and organizational strategies.

We wholeheartedly support the open and appropriate flow of electronic health information in order to create a seamless and connected world where everyone thrives. Cerner champions a level playing field where use, access and exchange of information is done on a non-discriminatory and interoperable basis.

Top 5 ways the ONC rule will benefit HIT

With this in mind, we see many positive points in the ONC’s proposed information blocking rule. Here are five of the most notable:

  1. Providing for appropriate, uninhibited and fair flow of electronic health information that empowers providers and authorized third parties to support the exchange of health information for consumer access, care delivery, population health and other legitimate purposes
  1. Doing away with “gag” clauses and contractual constraints that would impair free and fair communication about certified health information technology
  1. Setting the stage for the U.S. Core Data Set for Interoperability (USCDI) to be the essential data set used for standards-based health information exchange into the future
  1. Using the Standards Version Advancement Process to allow HIT developers to adopt updated versions of current interoperability specifications without compromising the standing of certified HIT
  1. Pushing for adoption of Application Programming Interfaces (APIs) so consumers and providers can use the applications of their choice to access electronic health record information

6 ways the ONC information blocking rule could be improved

Cerner also has some ideas for how the ONC’s proposed rule could be refined.

  1. Provide concrete ways the information blocking exceptions should be applied. For example, the ONC should distinguish between how the licensing exception is applied to cases where the capability to access, use or exchange electronic health information doesn’t exist versus cases where it does.
  1. Allow 36 months as a general rule for certification, rollout and adoption of new certified HIT capabilities that are related to Electronic Health Information Export, API services and the interoperability criteria that require the USCDI Version 1.
  1. Adopt the USCDI as the basis for Electronic Health Information Export so what is exportable can grow as new USCDI versions expand data in standard export formats that are interoperable between EHR systems.
  1. Give a clear statement on licensing interoperability elements for legacy licenses and agreements prior to adoption of a final rule.
  1. Allow direct agreements – with appropriate fee structures – between API technology suppliers and API users as application developers. ONC’s assumption that these agreements may only form between API technology suppliers and API data providers is too constraining. It doesn’t recognize that API technology suppliers and users often form deliberate collaborations to provide compatible marketplace solutions.
  1. Provide guidance on practical application of the information blocking exception for developing fees based on recovering costs, such as defining the principle of reasonable profits; identifying what costs should form the basis of fee development; determining how usage fees should be treated; and addressing what can be done to deal with cost recovery issues caused by an implementer who configures and uses HIT in non-standard ways.

The ONC proposed information blocking rule promises profound impact across the entire HIT community. As health care advances, electronic health information is no longer the domain of the entity that collected it. Now, it’s a community asset that supports the interests of patients and consumers, and this rule does more to advance that cause than anything that’s come before it. We urge a careful, clear and practical approach from ONC as it puts the Cures Act information blocking provisions into action. The future of health care IT depends on it.

Cerner offers a complete package of regulatory consulting services that are valuable no matter the regulatory measure. Learn more here

More Like This:

Podcast: Carolinas Healthcare’s Jeffrey Cleveland on Health Information Exchange Technology – Listen time: 10:29

Blog: Provider Information Blocking and Attestation-Part 1 – 6 minute read

Blog: Information Blocking Applied to Health IT Suppliers-Part 2 – 4 minute read