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3 Ways the Biden Admin, HHS Could Boost Patient Data Sharing

Effective and accurate patient data sharing could give a boost to public health organizations and decrease the spread of COVID-19.

The Biden administration could require enhanced patient data sharing, update EHR requirements, and increase API access to improve public health sharing and give experts the tools to mitigate the spread of COVID-19, according to Ben Moscovitch, project director of Health Information Technology at Pew Charitable Trusts.

“The Biden administration plans to work with Congress to respond to the coronavirus, but unless these issues are resolved, challenges with sharing data could continue to hamper efforts to track the virus’s spread and who has been vaccinated,” Moscovitch wrote in a recent Health Affairs blog post.

Enhance Patient Data Sharing

The need for faster and more reliable patient data access is key to slowing down the coronavirus pandemic. Gathering critical demographic data to effectively initiate contact tracing would aid public health organizations during the pandemic.

“Although health care providers generally collect from patients the demographic data needed to order lab tests and help public health officials track the effect of a disease on different populations, their systems often fail to communicate this information quickly and effectively to testing labs and public health authorities,” wrote Moscovitch.

“That’s because different electronic systems can’t seamlessly exchange data, and many facilities—such as pop-up testing sites—still use outdated methods, including fax machines, to communicate results,” he continued. “When labs don’t get the information from health care providers, they can’t report it to public health agencies. This limits the availability of important data and slows response time just when speed is essential.”

Gathering and exchanging patient vaccination information is critical to current and future COVID-19 vaccine campaigns, Moscovitch said.

The 21st Century Cures Act requires health IT vendors and providers to share patient data with all other healthcare organizations. Information blocking provisions carry a fine of up to $1 million.

“The Department of Health and Human Services (HHS) has the power to enforce the Cures Act, but so far has only proposed how it will penalize EHR vendors,” Moscovitch added. “HHS leaders can and should use their authority to enforce information sharing by clinicians and testing labs—an approach that can quickly be put in place through additional guidance or an interim final rule.”

Moscovitch recommended HHS ensure providers include patient data on all COVID-19 testing orders for the duration of COVID-19 by penalizing providers that do not follow the rules.

Update EHR Requirements to Support Public Health Reporting

Moscovitch recommended the Biden administration utilize the HITECH Act to set EHR requirements.

Specifically, Moscovitch said HHS could require EHR functions to support public health reporting in four areas:

  • Submitting full patient data sets on lab orders to track diseases
  • Transmitting case reports to public health organizations to accurately respond to public health threats
  • Communicating with immunization information systems to track patient vaccinations
  • Integrating syndromic surveillance to detect new disease outbreaks and hot spots

“HHS officials should require EHR systems to support each of those cases as a condition for certification and set standards—that EHR systems must follow—for capturing the right data and making it easily accessible to public health agencies,” Moscovitch continued. “But the fact that the standards are in place and the capabilities exist won’t ensure compliance; health care systems need a strong incentive to participate.”

Moscovitch said public health reporting could become a Centers for Medicare and Medicaid Services’ (CMS’) Promoting Interoperability Program requirement.

Increased API Access for Public Health

The ONC interoperability rule addresses information blocking and promotes the use of third-party apps and APIs for patient data access. This aligns directly with Pew’s health IT initiative, which focuses on enhancing patient data interoperability and EHR safety.

With an increase in telehealth visits during COVID-19, APIs are even more important because they allow different users to interact and exchange patient data. Individuals no longer have to go to medical offices to retrieve their medical records.

Under the interoperability rule, HHS said individuals do not have to pay for API access and can utilize their smartphones to retrieve patient data.

“Patients obviously benefit from free access to their own health data,” Moscovitch wrote. “But society will also benefit from having public health data available at no cost. As such, HHS should require that the use of APIs for public health reporting is free so that local, state, and federal governments can obtain the data they need. In fact, some vendors have recognized the importance of such data and have made API-based public health reporting free for COVID-19.”

Moscovitch said HHS could add further elements of patient medical records, such as x-ray images, travel history, and social determinants of health (SDOH) data to public health reporting.

“The Biden administration should expand that list to help provide a richer database for public health agencies to use and to equip patients with the information they need,” Moscovitch wrote. “For example, public health officials should have more information about which countries a patient has visited, allowing these officials to quickly track infectious disease outbreaks and other emerging health risks, including a viral pandemic.”

However, the ONC and HHS timelines to implement these rules are too far down the road to successfully curb the pandemic. The information blocking provisions and requirements compliance date is now April 5, 2021. The 2015 edition health IT certification criteria updates and the new standardized API functionality dates are now required by December 31, 2022.

Moscovitch recommended the Biden administration accelerate API implementation and deployment by not delaying the dates again.

“Thanks to the bipartisan work of Congress when he was vice president, the new president has the tools available to improve health information technology to fight the COVID-19 pandemic today and enhance public health surveillance for the future,” Moscovitch concluded. “These are extraordinary times, and the coronavirus has laid bare the problems we face with outdated health information technology. There’s no time to waste.”

Next Steps

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