On March 9, 2020 the Office of the National Coordinator for Health Information Technology (ONC) released its final rule on the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. Referred to by some people as the “Information Blocking Rule,” since this is the primary topic, the document actually covers a host of other issues related to interoperability driven primarily by requirements of the 21st Century Cures Act. In addition to the final rule itself you can read the ONC press release, a comparison between the proposed and final rules, and lots of other resources. The final rule was officially be published in the Federal Register on May 1, 2020.
In February 2020 the eHealth Initiative (eHI) published a new report, The State of Patient Matching in America, based on a survey of over 115 health information exchange (HIE) and provider organizations conducted by NextGate on their behalf. Over the past few years we have written numerous related blogs on the ONC PMAL Project, the GAO Report on Patient Matching, and an Update on Patient Matching Activities in the US. Patient matching is one of the areas called out by Congress in the 21st Century Cures Act for review and consideration.
Last week, the Office of the National Coordinator for Health Information Technology (ONC) released the final report from its Patient Matching, Aggregation, and Linking (PMAL) Project, as well as an additional report describing a pilot project to test the Patient Demographic Data Quality Framework (PDDQ) to Support Patient Matching that was released several years ago. Funded from June 2015 through September 2018 by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) through the Patient-Centered Outcomes Research (PCOR) Trust Fund, PMAL was one of the activities I described in an earlier blog entry.
The Final Report reviews the four challenged of patient matching and linking that the PMAL project attempted to address:
|See our blog on the ONC Final Rule (March 2020)|
On February 11, 2019 the Office of the National Coordinator for Health Information Technology (ONC) released its latest Notice of Proposed Rulemaking (NPRM) to Improve the Interoperability of Health Information. Referred to by some people as the “Information Blocking NPRM,” since this was the primary topic anticipated, the document actually covers a host of other topics related to interoperability driven primarily by requirements of the 21st Century Cures Act. Besides the initial text of the NPRM, ONC also released a set of summary slides and fact sheets to help explain the document.
Given the relatively minimal mention of core public health reporting certification criteria in this NPRM, there is still a fairly large potential impact on public health. Topics, descriptions, issues, impacts, and potential opportunities discussed in this article and associated documents are based on our careful read of the NPRM and related material. But please note that this information is voluminous and at times confusing. Ongoing discussion and review will attempt to clarify (and if necessary correct) initial ideas presented here.
In order to help focus the reader, I have prepared a detailed table of Public Health Issues, Impacts, and Opportunities (currently at Version 15) which will be updated periodically, as well as a separate detailed response to the ONC Patient Matching RFI and CMS Patient Matching RFI.
On January 15, 2019 the US Government Accountability Office (GAO) released a new report to Congress, Health Information Technology: Approaches and Challenges to Electronically Matching Patients’ Records across Providers. This report is in response to mandate in the 21st Century Cures Act for the GAO to study patient matching. To develop this report, GAO reviewed available literature and interviewed more than thirty-five stakeholders (who are not identified) over the course of a year.
I have written several blogs and a feature article on patient matching developments in the US. Similarly, this new GAO report is an excellent retrospective on industry efforts over the past several years. It includes a clear statement of the problem, good discussion on both barriers and progress to date, insights from the stakeholders interviewed on their practical issues, and a review of various initiatives by the Office of the National Coordinator for Health Information Technology (ONC) over the past several years. The footnotes alone are worth the read as they contain excellent sources and side comments.