Standards will Make or Break Efforts Toward ePA

By Janet Campbell (Epic), EHRA Public Policy Leadership Workgroup Vice Chair

This is part two in a four-part series examining the need for ePA, the barriers presented by the current environment, necessary capabilities, and functionality, and the EHR Association’s policy recommendations. Part one can be read here.

Streamlining the electronic prior authorization (ePA) process will require significant coordination and standardization across multiple domains within individual healthcare organizations, across dozens of health plans covering their patients, and across the health IT tools in use by every participant in the process.

Progress is being made by various stakeholders in terms of standards development. Notably, the Coverage Requirements Determination (CRD), Documentation Templates and Rules (DTR), and the Prior Authorization Support (PAS) implementation guides – all a part of the Da Vinci Project’s efforts to understand functional requirements, build consensus on a technical approach, pilot, and iterate – have resulted in significant progress toward the enablement of highly automated prior authorization workflows.

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“No Surprises Act” Regulations Raise Concerns

By Leigh Burchell (Allscripts), Chair, & Janet Campbell (Epic), Vice Chair,
EHRA Public Policy Leadership Workgroup

The growth in high deductible health plans requiring patients to shoulder more of their healthcare costs and the lack of transparency in healthcare pricing has exacerbated the issue of patients left with surprise medical bills that many cannot afford to pay. The urgent need to address these serious issues is why the EHRA supported the No Surprises Act when it was developed and welcomed the regulations published last year as a foundation upon which it can be implemented. 

However, we have several concerns about rulemaking to date as it relates to workability and the unnecessary burden it creates for industry stakeholders. To that end, we reached out proactively to regulatory agencies to provide feedback in four key areas that we believe – based on our member companies’ experiences and our ongoing advocacy for reasonable timelines and requirements – will be informative when it comes to additional regulatory actions expected later this year. 

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The USCDI Curation Process: Why Stratify?

By John Travis and members of the EHRA Information Blocking Task Force 

In our last blog on the United States Core Data for Interoperability (USCDI), the focus was on USCDI as the policy ground for advancing federal interests for promoting high impact needs for health data, and USCDI’s import as a certification specification impacting developers of Certified Health Information Technology (CHIT). In this blog, we focus on how the evolution and curation of USCDI impacts the efforts of health IT developers and implementers to “stay current.” 

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The Balance Challenge for Policy in Progressing the U.S. Core Data for Interoperability (USCDI)

By John Travis and members of the EHRA Information Blocking Task Force

 

With publication of the 21st Century Cures Act: Interoperability, Information Blocking , and ONC’s Certified Health IT program final rule (Cures Act Final Rule), the Office of the National Coordinator for Health IT (ONC) worked to implement important provisions of the 21st Century Cures Act (Cures Act) for nationwide interoperability. The initial proposal from ONC addressing the Trusted Exchange Framework and Cooperative Agreement (TEFCA), which was also required by the Cures Act, created a central role for the U.S. Core Data for Interoperability (USCDI) in federal health IT policy, and it is important to consider what that role will be in the national policy framework. Will the USCDI push the industry beyond where it would go on its own by being progressive in its version expansion? Will it affirm and codify an extension of the current state, adhering to a principle of expansion based on supporting pre-requisites of already established interoperability standards? Or something in between?

In recent deliberations of the USCDI Task Force of the Health Information Technology Advisory Committee (HITAC), the Federal Advisory Committee established under the Cures Act, this tension point has come to light. The members of the task force seem to have two perspectives on the matter. 

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Securing API-based Access to Patient Data

By EHRA Standards & Interoperability Workgroup

One of the goals of the 21st Century Cures Act’s health IT provisions was to enable patients to have secure access to their electronic health information using Application Programming Interfaces (APIs). The Office of the National Coordinator for Health IT (ONC) advanced that objective when it published its May 2020 Final Rule, which specifies HL7(R) FHIR(R)-based standards that health IT developers (as well as provider organizations developing their own solutions) will be expected to implement so that patient can access their health data using apps of their choice, connected to APIs. But how can patients be assured that their health information is secure once it leaves the EHR? 

Health data are among an individual’s most sensitive information, obligating all members of the healthcare community to protect patient privacy by ensuring secure data exchange. This blog post will review how the ONC standards for patient access can enable best practices to securely share patient health data.

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A Focus on Standards 

Screen Shot 2019-07-04 at 6.19.08 PMOn June 3, EHRA submitted feedback to ONC on its proposed rule, the  21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. In this feedback, EHRA members drew on both their expertise as software developers and as contributors to standards work across the health IT industry. 

One theme of EHRA and other stakeholders’ feedback is that a focus on standards is critical. A particular standard proposed recently by ONC is the United States Core Data for Interoperability, or USCDI. USCDI “is a standardized set of health data classes and constituent data elements for nationwide, interoperable health information exchange” and includes important health data classes. 

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