Stakeholders growing impatient, urge feds to release final rules

It’s been about a year since the Department of Health and Human Services first proposed rules to make patient medical records more accessible, which have yet to be finalized—much to the dismay of some stakeholders.

A coalition of nearly 30 healthcare providers and tech companies--including the American Academy of Family Physicians, Apple, IBM and Microsoft—sent a letter on Thursday to HHS and the Office of Management and Budget, urging them to “expeditiously finalize” the health IT regulations, which they contend would “revolutionize” the exchange of medical records.

However, as the stakeholders point out, the problem is that the two separate but related rules—proposed by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for HIT, respectively—are still under review by OMB.


“We strongly urge the administration to finalize these rules without further delay to help ensure that patients, providers and clinicians have more complete health information wherever and whenever they need it,” states the letter. “We urge you to support ONC and CMS’ approach and expeditiously finalize the proposed regulations so that patients and healthcare providers can better access and use the data in records to improve the coordination, quality and safety of care.”

Last March, ONC issued a proposed rule requiring healthcare providers to offer patients access to their electronic health information through secure, standards-based application programming interfaces (APIs).

“CMS is proposing that Medicare and Medicaid plans also make claims information available to their members using APIs,” according to the stakeholders. “APIs can make it easier for patients to obtain their data on personal devices, such as smartphones or tablets, and aggregate their own records from many different healthcare providers and health plans to be able to take greater ownership of their care.”

In particular, the letter notes that ONC’s proposed rule has garnered “significant support” from a broad array of stakeholder groups including EHR vendors, healthcare providers and public health organizations.

However, some prominent stakeholders have voiced their criticism of the proposed ONC rule. The American Medical Association and EHR vendor Epic Systems contend that—absent appropriate privacy protections—the finalization of ONC’s proposed rule, as written, would put patient information at risk.

Epic issued a statement on Monday about the pending ONC rule, which the company contends inadvertently creates “serious risks” to privacy by requiring providers to send patient data to API-enabled apps requested by patients.

In response, CMS Administrator Seema Verma said on Wednesday that “the disingenuous efforts by certain private actors to use privacy—as vile as it is—as a pretext for holding patient data hostage is an embarrassment to the industry.”

Nonetheless, Thursday’s letter to HHS and OMB—from organization who support ONC’s approach—makes the case that “by finalizing the rules, the administration can provide patients, technology developers and healthcare providers with clarity on API requirements so that these stakeholders can continue to work with government on private sector and policy solutions to increase the privacy and security of data exchange no matter where the data reside."