What is Information Blocking? 

By the EHR Association Information Blocking Compliance Task Force

This blog marks the beginning of a series by the EHR Association on information blocking – what it is and what the “reasonable and necessary activities” are that constitute exceptions as defined by ASTP/ONC regulations. Given that it has been five years since the initial release of information blocking regulations and the recent renewal of focus on enforcing the law, this is an opportune time for a refresher on the topic.

Our goal with this series is to educate our membership and other impacted stakeholders on information blocking requirements and exceptions. This first installment shares the history and description of information blocking requirements. Future blogs will illustrate how we expect exceptions to be used and will highlight ambiguities and/or challenges with the framework that we believe will be insightful to regulators and other interested parties. 

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Dr. Thomas Keane to Lead ASTP/ONC

“The EHR Association congratulates Dr. Thomas Keane on his appointment as Assistant Secretary for Technology Policy at HHS and National Coordinator for Health IT. Dr. Keane brings important expertise in health policy to the role,” says Leigh Burchell (Altera Digital Health), Chair of the EHR Association Executive Committee. “We’re pleased that his selection reflects HHS’ commitment to putting leadership in place that both recognizes the criticality of the ‘coordinator’ responsibilities and understands from prior experience the many complex use cases related to health data interoperability that the agency is tasked with supporting. We look forward to collaborating with Dr. Keane and ASTP to further the digitization of healthcare and explore regulatory refinements.”

Among other duties, Keane was an administrator of the COVID-19 Provider Relief Fund and led the development of the AHRQ National Nursing Home COVID Action Network. Dr. Keane worked as a finite element software developer and enterprise software engineer before training as an interventional radiologist.

Finding the Right Balance: Smart Deregulation in Health IT

by Leigh Burchell (Altera Digital Health), Chair, EHR Association Executive Committee

The current administration has made deregulation a central policy priority, aiming to reduce burden and costs in as many sectors of the economy as possible, including health care. This is exemplified by the January 2025 Executive Order 14192: Unleashing Prosperity Through Deregulation, which requires federal agencies to eliminate ten regulations for each new one introduced. 

As the trade association for health IT developers, we believe that smart deregulation should focus on removing outdated, redundant, and low-value requirements with ASTP/ONC and CMS playing a role more focused on driving improvements in standardized interoperability and health data exchange. Health IT regulation should support—not hinder—the industry’s collective ability to deliver safe, effective, and innovative technology solutions, without compromising the progress made or devaluing the investments in health IT over the last fifteen years. As always, we remain committed to working alongside federal agencies within the construct of a regulatory environment that benefits providers, developers, and—most importantly—patients.

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EHR Association Statement on HTI-2 Final Rule

Following is the statement from the EHR Association on the Dec. 11, 2024 publication by ASTP/ONC of the Health Data, Technology, and Interoperability: Trusted Exchange Framework and Common Agreement (HTI-2) Final Rule, which will publish in the Federal Register on Dec. 16, 2024. The scaled-based rule finalizes certain proposals related to the Trusted Exchange Framework and Common Agreement (TEFCA). It also amends the information blocking regulations by including definitions related to the TEFCA Manner Exception and implements provisions to support the reliability, privacy, security, and trust within TEFCA.

“This first rule finalizing parts of the HTI-2 proposals was released on December 11, 2024, and the focus on TEFCA allows ASTP to solidify pillars of that program that outgoing leadership wants to leave as a legacy. We expect the remaining components of the HTI-2 proposed rule to be split into multiple other final rules. In doing so, the EHR Association hopes that ASTP/ONC will prioritize the necessary additional technical corrections specific to health IT vendors, the most urgent of which relate to Insights Measures. As currently drafted, the Insights Measures are likely to produce data of questionable value – something we have been stressing to ASTP since publication of the HTI-1 proposed rule in 2023. As we inch closer to the January 1, 2026, start date, the uncertainty of finalized measurements creates challenges. We hope that future rules finalizing HTI-2 proposals will include helpful and necessary clarifications.”

Election 2024: Potential Impacts on Health IT

By Stephanie Jamison (Greenway Health), Chair, EHR Association Executive Committee

With a new administration poised to enter office and Republicans set to control both the House and Senate, the anticipated impact of the 2024 election on health IT policy is a question many in the industry are contemplating as they consider policy priorities for the year ahead. 

In assessing what to expect from the next four years, we can consider both the previous Trump Administration and those areas where Congress has been vocal in its desire to put forward legislation. While the assumption is that healthcare is unlikely to be the highest priority for either the incoming administration or Congress—the most urgent focus areas will likely be border security, tax, trade, energy, and environmental regulations—technology is top-of-mind in many areas. Legislation addressing AI, cybersecurity, and data privacy is expected to be a focal point of a new Congress.

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HHS Establishes ASTP/ONC

On July 25, 2024, HHS announced it had reorganized its technology, cybersecurity, data, and AI strategy and policy functions to “streamline and bolster technology, cybersecurity, data, and artificial intelligence (AI) strategy and policy functions.” Historically, responsibility for policy and operations has been distributed across the ONC, ASA, and ASPR. Now those responsibilities have been consolidated into the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology, or ASTP/ONC.

In response to this announcement, the EHR Association issued the following statement:

“In establishing ASTP/ONC, HHS is acknowledging the increasingly important role of health IT in the care delivery system since the inception of ONC 20 years ago, as well as the critical role electronic patient data plays in the provision of and access to quality care. ONC has collaborated with the health IT industry as we have expanded patient access to their data, the exchange of health information between numerous stakeholders, and now the rapidly growing influence of AI.

“Along with great potential, these changes bring heightened privacy and security risks and the need for a fresh approach to policy, standards, and strategy to address the complex nature of health information technology. The EHR Association believes the new ASTP/ONC can add great value in expanding even further the work they do to coordinate health IT-related policy across the Federal government.

“We look forward to collaborating with ASTP/ONC as we work toward our shared goals of continually improving the quality and efficiency of care through safe, innovative interoperable health IT adoption and use.”

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