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I quickly became convinced that privacy was in no way the true obstacle to data sharing. It was the cover for the other anti-competitive concerns bubbling underneath.

Today, the Centers for Medicare & Medicaid Services (CMS) passed a final rule that promotes data sharing, patient access to health information, coordinated care, and interoperability to streamline the prior authorization process.The rule is the next phase of CMS interoperability rulemaking, aimed at improving data exchange while reducing provider and patient burden.The CMS Interoperability and Prior Authorization rule will allow certain payers, providers, and patients to have electronic access to pending and active prior authorization decisions. This is expected to cut back on repeated requests for prior authorizations, thereby reducing costs and administrative burden so providers can deliver higher quality care.

Today, patients, caregivers, and clinicians struggle with information exchange barriers due to the separation of clinical and administrative data. The effect of this is especially clear in the case of prior authorization, where inefficient information exchange can significantly delay or obstruct patient access to treatment and payment for healthcare services. Clinicians also report that finding and exchanging information for prior authorization is a major source of burden. To structure its recommendations, the ICAD Task Force developed a series of guiding principles to make sure the recommendations addressed the gaps between the present and ideal state.

As National Coordinator for Health IT, the interoperability veteran will bring deep standards expertise as the rubber hits the road on nationwide API-based data exchange.

Pew Charitable Trusts explained why the government needs to enforce the ONC interoperability rule to help slow down the spread of COVID-19.

However, the corrective action plan noted that in signing the settlement with OCR, Banner Health is not admitting liability.

Changes and Clarifications from the Proposed Rule to the Final Rule

n general, actors can no longer engage in practices that interfere with the access, exchange, or use of electronic health information unless the practices are required by applicable law(s) or if an actor meets an exception established by the HHS Secretary. My companion blog post To share or not to share, whats an exception (to information blocking)? unpacks the exceptions we established in the Cures Act Final Rule to address privacy, security, and a host of other issues.

This final rule, in turn, flows from CMSs MyHealthEData initiative, which focused on giving patients easy and direct access to their medical data. The agency has attempted to not only make patient health data more accessible, but has also worked to educate patients on the value of engaging with that data.All well and good. However, while this stepwise approach to expanding health data interoperability seems relatively sound, particularly given that patients were given a seat at the data buffet table, one shouldnt forget that there are still some serious interoperability issues remaining unresolved.