College warns, however, that ‘information overload’ could actually hinder care
April 5, 2019 (ACP) – As members of Congress monitor the federal government's progress toward updating and reforming health information technology, the American College of Physicians is making sure that legislators understand what must be done to protect patients and their medical teams.
“We're concerned about the complexity of the proposed regulations and how these regulations will affect physicians in their everyday practice,” said Brooke Rockwern, an associate for health IT policy at ACP. “We also continue to warn about the federal government's approach to improve interoperability, which is focused on moving large quantities of data from one place to another. We're worried this will open the floodgates, leading to an inevitable information overload.”
ACP expressed its concerns in a statement sent to the U.S. Senate's Committee on Health, Education, Labor and Pensions before a hearing it held March 26 on making electronic health information available to patients and providers. That's part of what's covered by the 21st Century Cures Act, which Congress passed in 2016.
The act set standards regarding interoperability (the ability of electronic health record software programs to talk to each other) and information blocking (interfering with the exchange of electronic health information). Congress told the Office of the National Coordinator for Health IT to work out the details, such as exceptions to rules regarding information blocking.
In its statement, ACP told the committee about several concerns. A key one, Rockwern said, is that “proposed regulations overlap with longstanding HIPAA regulations, and physicians will be left trying to decipher what information is required versus permitted to be sent based on any given patient.”
“This will add a significant amount of complexity and burden to their existing workflows,” she said.
In addition, ACP warned that proposed interoperability rules would overwhelm physicians.
“Clinicians do not need access to every element of a patient's electronic health information,” Rockwern said. “In some cases, having access to every element of data can, in fact, hinder care delivery.”
ACP told the committee that it supports the adoption of technical improvements such as Fast Healthcare Interoperability Resource (FHIR) standards, Rockwern said, and that the College also supports allowing patients and their physicians to have seamless access to health information.
“However,” she said, “we are concerned about patient privacy issues that will arise when we allow third-party app developers to access electronic health information on behalf of the patient when the patient is unaware of who they are actually allowing to access their data.”
ACP also expressed concern that proposed timelines for adoption of the new rules do not properly align.
“For example, the information-blocking provisions will technically go into effect prior to vendors being required to provide the necessary functionality to share the information,” Rockwern said.
In addition, ACP noted that timelines must reflect the need for implementation, testing and training. “Physicians should not be rushed through that process to meet a regulatory deadline,” she said.
Rockwern said that the committee is likely to hold additional hearings on the proposed regulations. “ACP is in the process of developing our comments to submit through the formal rule-making process,” she said. “Those are due May 3. However, a number of organizations have requested an extension on the comment deadline. We support them and will stay tuned to see if the request is granted.”
ACP's statement to the Senate committee is available on the College's website.
The Office of the National Coordinator for Health IT has information sheets on its website that provide details on information blocking and other health IT issues.