CMS releases new data exchange rule for health records

The federal government has released a proposed rule designed to make electronic health records from different commercial developers share data and work together.

The rule from the Office of the National Coordinator for Health IT (ONC), part of the Centers for Medicare and Medicaid Services, is based on longstanding plans by ONC to build an interoperable health data system in which health care providers can share data, with an eye to lowering costs, reducing duplicative tests and information gathering, and giving patients a platform for accessing their own health data.

The proposed regulations in the 431-page document released March 20 would create a regulatory framework around the "interoperability roadmap" ONC released this January. The new rule would update the requirements for ONC certification of EHRs to include data portability and a standardized data dictionary. The new rule also would require the adoption of application programming interface functionality to facilitate data exchange. Additionally, it would extend health IT certification to categories of providers who aren't eligible for EHR adoption subsidies granted by Congress as part of the 2009 economic stimulus, including mental health and long-term care providers.

Other changes include new requirements for price transparency among vendors, to disclose potentially hidden costs of data exchange among systems, and costs associated with changing or upgrading systems. The rule also would expand the categories of information captured during the testing of certified health IT products. ONC intends to release that information as open data, in machine readable format, within the next 18 months.

The specifics of the new rule likely won't come as much of a surprise to any of the leading EHR providers. The path toward interoperability rules has included industry and stakeholder participation in federal advisory committees designed to foster a degree of consensus on what a health record should contain, and the rules of the road for exchanging information by competing systems.

"ONC's proposed rule will be an integral component in the shared nationwide effort to achieve an interoperable health system," said Karen DeSalvo, National Coordinator for Health IT.

According to CMS, more than 433,000 medical providers and hospitals have received incentives for EHR adoption since a $30 billion incentive program launched in 2011 – that's about 95 percent of hospitals and 60 percent of eligible practitioners.

The interoperability rule accompanied the release of the proposed rule for the third and final stage of the Meaningful Use regime, under which providers attest to their use of certified electronic health records in order to qualify for incentive payments, and avoid getting hit with penalties in their Medicare compensation that begin in 2018.

The comment period on the proposed rule ends May 29.