As technology’s role in both healthcare and senior care continues to evolve and expand, rules governing use can be quite complex.
At the HIMSS19 conference, much of the talk focused on the Office of the National Coordinator for Health IT’s proposed rule focusing on patient access to information and information blocking. In theory, the rule — which proposes adoption of Fast Healthcare Interoperability Resource (FHIR) standards to support the secure flow of information — would lead to consumers accessing their health information in real time via smartphones and other devices and becoming better partners in their own care, according to CMS Administrator Seema Verma.
The rule was met with praise from many industry stakeholders. Former Health and Human Services Secretary Mike Leavitt called the rule “transformative” for consumerism in healthcare, while former National Coordinator for Health IT Karen DeSalvo talked about its potential to improve public health.
The American Hospital Association, however, expressed apprehension about the rule’s inclusion of event notification as a condition of participation for Medicare and Medicaid.
“We believe that CMS already has better levers to ensure the exchange of appropriate health information for patients,” Ashley Thompson, AHA senior vice president for public policy analysis and development, said in a statement. “We recommend the agency focus on building this exchange infrastructure rather than layering additional requirements on hospitals.”
What’s more, the density of the proposed rule caused the HIMSS Electronic Health Record Association to ask for additional time for review. “The proposed rule from ONC is a substantive one,” a letter from the EHRA to National Coordinator for Health IT Donald Rucker says. “It suggests complicated, significant adjustments to the regulations already governing the health information and technology industry, and stakeholders deserve adequate time to provide thoughtful, detailed comments on the impacts of the proposals.”
Federal and state policymakers must try to account for a plethora of different scenarios while also balancing opinions and requests from various stakeholders impacted both directly and indirectly. The importance of health IT professionals and providers paying attention to the regulatory landscape cannot be overstated.
Telehealth Regulations Are Promising but Complex
Telehealth is another area where navigating rules can be challenging.
Many stakeholders have lauded recent steps taken by the Centers for Medicare & Medicaid Services to help providers better benefit from offering telehealth to their patients. Of one effort in particular, a November final rule published by CMS for the 2019 Physician Fee Schedule that included a new code designated for virtual check-ins, providers and vendors alike at HIMSS expressed excitement about the agency’s direction. The code will enable providers to be reimbursed for the delivery of synchronous, two-way audio interactions enhanced with video or other kinds of data transmission.
“There’s been a lot of federal movement in the last year or so, which has been nice,” said Shawn Valenta, administrator of telehealth for the Medical University of South Carolina. “There have been a lot of barriers.”
What’s more, in October, CMS published a proposal to allow Medicare Advantage plans to offer telehealth benefits, regardless of whether a policyholder lives in an urban or rural area. That proposal could have big implications for expanding access to telehealth services for seniors.
Still, reimbursement issues — and even issues around definitions — continue to loom, especially at the state level. The Georgia Senate in February recently passed two bills, according to mHealth Intelligence. One bill, SB 115, allows providers in other states to treat Georgia residents as long as they meet any applicable laws. The second, SB 118, proposes new definitions for telehealth and telemedicine. Telehealth, it says, would be defined as “the use of information and communications technologies, including, but not limited to, telephones, remote patient monitoring devices or other electronic means.” The bill states that a patient must be at “an originating site” and a provider must be at a “distant site.”
Keeping up with these and other regulations may seem like a daunting task, especially for providers more concerned with caring for patients on a day-to-day basis. Ultimately, though, being mindful of the regulatory landscape is necessary to have a good sense of where a health IT initiative currently stands and the potential challenges that lie ahead.