POCP Blog

By Tony Schueth

The 21^st Century Cures Act is now the law of the land. As you’ve probably heard by now, this bipartisan, $6.3 billion piece of legislation is intended to expand medical research and speed up approval of new drugs and medical devices. Parts of the law have received considerable media attention, including the $1.8 billion for the cancer research “moonshot” championed by Vice President Joe Biden, as well funding to address the opioid epidemic and expand access to mental health services. What the media hasn’t covered is a huge chunk of the law (aka Title IV–Delivery), which mostly deals with health information technology (health IT). 

To save you the trouble of poring through Title IV in the nearly 1,000 page law, here’s a brief overview of what it contains relative to health IT. We’ll do a deeper dive on what it means in the January 2017 issue of HIT Perspectives.

• Section 4001: Assisting Doctors and Hospitals in Improving Quality of Care for Patients.  Provisions in this section would “encourage” certification of health IT for specialty providers—pediatricians were mentioned—and sites of service.  Other provisions would address the “burden,” such as documentation requirements, related to various programs, including Meaningful Use and the Medicare Incentive Payment System.  This will be done through public comment and prioritization of these requirements under the auspices of the National Coordinator for Health IT (ONC).
• Section 4002: Transparent Reporting on Usability, Security and Functionality. A big chunk of this addresses EHRs and information blocking. It talks about prohibiting certification for offending systems and allows the Secretary of the Department of Health and Human Services (HHS) to take action to “discourage noncompliance, as appropriate,” such as through decertification of noncompliant systems.
• Section 4003: Interoperability. This section calls for creation and support of a model framework for the “trusted” and secure exchange of health information, as well as the creation of a digital directory of providers and facilities. It also calls for combining the HIT Policy and Standards Advisory Committees to create the HIT Advisory Committee. The new Committee will identify priorities for standards adoption as well as address issues related to interoperability, privacy and security.
• Section 4004: Information Blocking. This creates the ability (or authority, in government speak) for the government to enforce anti-information blocking provisions.  It allows for the HHS Office of the Inspector General to investigate claims of information blocking and assign penalties (fines) for those found to be in violation.
• Section 4005: Leveraging Electronic Health Records to Improve Patient Care. This section promotes the exchange of health information between registries and EHRs. It also gives health IT developers standing in patient safety organizations to report on patient safety issues and conduct activities related to patient safety.
• Section 4006: Empowering Patients and Improving Patient Access to their Electronic Health Information. This section supports the certification and development of patient-centered EHRs, including the addition of patient usability to EHR certification criteria. It emphasizes use of health information exchanges and requires HHS to educate doctors about allowable uses and sharing of patient health information.
• Section 4007: GAO Study on Patient Matching. This section requires the General Accountability Office (GAO) to conduct a study on methods for securely and accurately matching patients to their records. [Click here for our primer on this issue, which was in the November issue of HIT Perspectives].
• Section 4008: GAO Study on Patient Access to Health Information. This section calls for the GAO to carry out a review of patient access to health information, including barriers and methods patients may use for requesting their personal health information.
• Section 4013: Telehealth Services in Medicare. This section aims to ultimately help the government increase use of telehealth services by Medicare, such as identifying patient populations who could benefit from the technology and barriers to adoption.

It’s plain to see that Congress clearly believes health IT is part of the solution, not the problem. So what do all these provisions mean for health IT?  Stay tuned for our article next month.

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