From the August 2019 issue of HealthCare Business News magazine

The ONC also has specific programs to interconnect health information exchanges (HIEs) and health information networks (HINs) under the standards established by the Trusted Exchange Framework and Common Agreement (TEFCA).

Data sharing and HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides a workable foundation for data sharing. In contrast to the complex and incomprehensible End User License Agreements (EULAs) that consumers face whenever acquiring a new piece of software, HIPAA has enumerated uses for treatment, payment and operations, which provides operational clarity for secondary uses of data while still insuring privacy.

But HIPAA has often been perversely interpreted over the years, typically to justify a refusal to share data. The Cures Act takes specific aim at data blocking, which is explicitly illegal. Rules are being created to define allowable exceptions, but the goal is to make these exceptions explicit and limited.

Most importantly, the Cures Act aims to eliminate the barriers patients currently face accessing their own medical records. Institutions often raise procedural and financial hurdles for patients, who end up suffering the most from the deficiencies in the current system of information exchange. Ultimately, it must be patients who control their own data, not clinicians or vendors.

Sharing or consequences
While specifics are still being worked out, there will be clear consequences for failing to comply with the requirements for data sharing. Electronic medical record (EMR) providers, HIEs and HINs are the entities subject to civil and monetary penalties of up to $1 million “per event” enforced by the Office of the Inspector General.

Perverse incentives, status quo bias and entrenched competitiveness have all contributed to a suboptimal system, where information is too often inaccessible. The problems are both technical and procedural. The change will be difficult and expensive, and no market participant will change unless there are clear positive and negative incentives, and coordination so that everyone moves forward together.

With these incentives in place and a clear path forward, eager healthcare innovators will gain access to the data needed to create the next generation of healthcare technology.

About the author: Matthew Michela is the president and CEO at Life Image.
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August 2019 Magazine

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