Addressing Steps, Challenges Health Orgs Must Meet Toward CMS, ONC Interoperability Rules

November 11, 2020
Briana Contreras
Briana Contreras

MHE's Briana Contreras spoke with Matthew Michela, President and CEO of Life Image, the world’s largest medical evidence and image exchange network. The two delved through the specific steps each type of healthcare organization - from health systems, payers and IT companies - must follow to comply to meet the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services' (CMS) new interoperability and patient access rules.

As healthcare organizations like - health systems, payers and IT companies - prepare to meet the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services' (CMS) new interoperability and patient access rules, Matthew Michela, president and CEO of Life Image, breaks down the steps and challenges these organizations will have to work through.

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In the beginning of the Trump administration, efforts to share data among thousands of health entities in a much smoother process and make it more accessible were created through these new CMS and ONC interoperability rules. It's more likely organizations will have to meet the guidelines of these rules when they become affective in 2021 and 2022.

According to Michela, these rules are split into three branches.

One is from a technology point of view where every organization should create their standard interfaces and integration so data can easily pass between them, get out of the historical issues of where you can't get it, or in order to get it, you have to spend millions of dollars in three years of IT work in order to be able to see this data to create a common standard, he says.

The second is allowing access to patients to their own data in a way that is more easily accomplished. In depth, these are regulations against data blocking. How it works is providers will give data to patients more easily so they can get treatment elsewhere, or so they know how much they paid for services and how much they're going to pay for services beforehand, etc.

The third of the rules is the compliance, Michela adds. This third branch means if you don't do these things, then there's going to be consequences such as major fines.

In order for different types of organizations such as larger health systems and rural hospitals to meet these guidelines, Michela first recommends leaning on vendors like EHR, image vendors and more, because "interoperability is not a something you can necessarily do and weeks and necessarily months."

Michela adds communication with vendors will ease challenges many health systems could face in this process.

"So the first thing they have to do is have to go to their vendors," he says. "Talk about 'what are you doing for interoperability?' And 'what are you doing with your product and service to make sure that it is compliant with what we need,' they have to do that."

"(Next) you have to make sure that you do a proper vendor evaluation process, you got to do your due diligence on it, because there's so much demand out there. You don't want partners who are going to over promise they can help you and solve these things and then fall short because your procurement folks haven't done a serious enough look. The careful vendor and partner evaluation process is really the first thing, but rely on others to do it. Make sure that they understand that there's consequences to them if they don't comply. And you've got to project manage it."

Though working toward meeting these requirements may bring challenges, it's an opportunity to transform healthcare, Michela says.

"When you reduce these barriers, you accelerate access to information," he says. "When you empower patients they seek out quality and better costs; they seek out their own options. When you accelerate access to data, you accelerate drug development.

He adds the interoperability rules will Improve quality and save lives.

"This is what most of us have been living for for decades," he says.