“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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TEFCA Signals Progress, With Work To Be Done

By EHRA Public Policy Leadership Workgroup

After a journey more than four years in the making, the Office of the National Coordinator for Health IT (ONC) and The Sequoia Project achieved a major milestone in the advancement of nationwide health information exchange: the publication of the Trusted Exchange Framework and Common Agreement (TEFCA) v1.0. ONC and The Sequoia Project have demonstrated their commitment to incorporating input from stakeholders across the industry, which created a process that produced significant improvements with each draft publication. We applaud the significant efforts undertaken by ONC and The Sequoia Project to collaborate with industry interoperability experts and create a framework that incorporates key principles of trusted exchange, like reciprocity, as well as a technical approach that leverages commonly adopted standards. 

For well over a decade, members of the Electronic Health Record Association (EHRA) have invested substantially in advancing the data sharing capabilities of the health IT systems used by healthcare organizations across the country with the belief that doing so will improve the quality and efficiency of health care. It is our sincere hope that TEFCA will continue to build on those investments for the benefit of patients.  

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The Case for Telehealth Reform

By the EHR Association

The expanded access to telehealth enabled under the COVID-19 public health emergency (PHE) has been transformational and served to engrain virtual care into the nation’s healthcare landscape – improving access and outcomes. Healthcare providers have risen to the challenge of meeting patients’ expectations for telehealth services by making substantial investments into new technologies that have so far carried them through the pandemic. 

However, despite ongoing surges and the emergence of new variants, many of the telehealth flexibilities that have helped dramatically improve patient access to care will expire later this year unless the Biden Administration extends the COVID-19 PHE  – which must be renewed every 90 days. Should that happen, the impact to public health programs and private healthcare delivery alike will be significant. 

Even if the PHE is extended, the uncertainty generated by its temporary nature is impacting all aspects of healthcare.

Even if the PHE is extended, the uncertainty generated by its temporary nature is impacting all aspects of healthcare. Healthcare organizations must decide if they can risk dedicating finite financial resources to maintaining the technological and clinical infrastructure required to continue offering telehealth programs at the level to which patients are now accustomed, when the possibility exists that Congress may ultimately decide against making the changes allowed under the PHE permanent.

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Congratulations & Thank You

By Barbara Hobbs, Chair, EHRA Membership Committee

The EHRA would not be possible without members – backed by their organizations – who are willing to dedicate time, expertise and other resources needed to work toward our mission of accelerated health IT adoption and interoperability, use of data to improve the efficiency of care delivery and advancing patient outcomes through enhanced quality.

As we move on from 2021, we want to take this opportunity to extend a very special thank you to the volunteers who keep EHRA running. In particular, we’d like to congratulate Barbara Hillock of Harris Healthcare, who was named our 2021 Most Active EHRA Individual Member, and Medsphere, the 2021 Most Active EHRA Member Company.

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New Guide Offers Guidance for Digitizing Opioid Tapering Plans

By Daniel Seltzer, Co-chair of the EHRA Opioid Crisis Task Force

Care disruptions due to the COVID-19 pandemic and other ongoing events have put long-term opioid therapy (LTOT) patients at increased risk for opioid-related harm and heightened the urgency around addressing the opioid crisis. This has, in turn, presented a significant opportunity to leverage technology to improve certain care processes around opioid therapy, starting with digitizing the tapering plan and incorporating existing clinical practice guidelines into clinical decision support (CDS) tools. 

These are areas that have been researched extensively by EHRA’s Opioid Crisis Task Force, which was formed in 2018 to explore and recommend ways EHR technology can help solve the complex opioid crisis puzzle. This research culminated in the newly released Opioid Tapering Implementation Guide for Electronic Health Records, a set of clinical practice guidelines that can be operationalized to improve opioid stewardship and opioid tapering in clinical practice. 

EHRA’s goal with this Opioid Tapering Guide is to enable an organization’s health IT team to implement tapering best practices more rapidly using EHR-based CDS tools. The EHR developer community can also use it to steer the future development of new or updated products and services that can help hospitals, physician practices and other care environments implement these and other best practices. 

In developing the guide, the Task Force leveraged evidence-based guidelines on opioid tapering published by several organizations and agencies with subject matter expertise, including clinical recommendations from the United States CDC, VA/DOD, and HHS. These referenced guidelines include tapering plans for pain lasting longer than three months or past the normal tissue healing time frame, outside of active cancer treatment and palliative or end-of-life care. 

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Phishing and Ransomware – The Gruesome Twosome of Cyber Attacks

By Nam Nguyen, Vice Chair
EHRA Privacy & Security Workgroup

October is Cybersecurity Awareness Month, and the Electronic Health Record Association (EHRA) will use this opportunity to share helpful reminders of cybersecurity fundamentals throughout the month. 

The 2020 HIMSS Cybersecurity Survey provides a look into cybersecurity issues facing US healthcare organizations. Based upon the feedback from 168 US-based healthcare cybersecurity professionals, “Significant security incidents continue to plague healthcare organizations of all types and sizes. Phishing is the most common type of significant security incident.”

Phishing and ransomware are the one-two punch of significant cyber risks. Phishing is typically the initial hook for significant security incidents, and occurs when a bad actor targets a user by email, telephone, or text message, posing as a legitimate company or organization to persuade the user to provide sensitive information, such as personal identifiers, banking information, credit card information and passwords. 

Using phishing tactics, a hacker can pose as an organization to get login information from an employee. Then using the login information they stole, place ransomware in the employer company’s critical systems.

Ransomware is malicious software that blocks access to an organization’s critical computer systems until a sum of money, the ransom, is paid. The FBI and the Cybersecurity and Infrastructure Security Agency (CISA) have published guidance urging victim organizations not to pay ransoms; they warn that paying hackers does not guarantee data will be returned and may encourage future strikes.   

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