Many Healthcare Organizations Aren't Ready for the Now Enforced ONC Cures Act Final Rule

A month prior to the Office of the National Coordinator for Health IT (ONC) enforcing the final rule of the Cures Act of information blocking and improving interoperability provisions, many health organizations did not meet these basic interoperability standards. As of April 5, the final ONC rules are now effective.

This information was found in a recent survey by Life Image, a medical evidence network for clinical and imaging data, which was deployed this March to nearly 4,000 clinical, technology and administrative leaders from provider, payer, IT, and other organizations.

The survey shared there was a broad lack of awareness and readiness to comply with the federal information blocking rules, which may indicate general confusion around rule requirements and the specific steps organizations must take to prepare.

The final ONC rules aim to improve electronic access, exchange, and use of health information, granting patients ownership of their health data without special effort or additional cost. While 70% of participants in the Life Image survey stated they were aware of the rules going into effect, up to half of the same participants also reported using practices defined by ONC as information blocking and will be noncompliant under the new rules – such as sharing records by paper or CDs, or charging patients fees to obtain records.

Further key findings from the survey include:

• Nearly half of the respondents had either not made any changes or did not know how to ensure their facility meets all of the rule requirements.
• A majority of healthcare organizations reported not using digital solutions to share healthcare data with patients, with 66% still using paper and 32% using CDs.
• 47% were not familiar with the term “information blocking.”
• 48% were not aware of practices or policies that would be considered “information blocking.”
• 39% did not know they could incur civil monetary penalties for information blocking practices/
• 15% currently charge $25 or more for patients to obtain records.

“Our recent survey validates what Life Image has been witnessing across the healthcare ecosystem in terms of interoperability readiness. While the COVID-19 pandemic created massive challenges and delayed many interoperability initiatives, it also underscored the paramount importance of the final ONC rules for advancing patient care and driving innovation,” said Matthew A. Michela, President and CEO, Life Image. “As many organizations are facing a long, complicated journey to ONC compliance, we’re dedicated to helping the industry navigate this new data revolution.”

According to HIPAA regulations, providers must give patients, upon request, access to their protected health information in the form and format of the individual’s choosing, including electronic format and via third-party application. In order to address ongoing industry resistance and barriers to interoperability, in March 2020 the ONC released the Final Cures Act Rule, which is grounded in the 21st Century Cures Act and mandates that patients be allowed greater control and access to their health data, targeting vendors and technologies that block information access.

How to comply for patients
In order for different types of organizations, such as larger health systems or rural hospitals to meet these guidelines, Michela 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."

He 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."