Regulators are Cracking Down on Provider Data Blocking Practices. Here’s What Healthcare Organizations Should Know

By Cristin Gardner

Patient access to medical data is a persistent problem that does not discriminate. Whether it’s a 38-year-old man seeking a second opinion for a nodule found on his lung, or a 55-year-old woman with a family history of breast cancer who recently moved and needs to share her prior exams with her new breast health specialist, both have equal needs and challenges to obtaining this important information. It is no secret that gaining access to healthcare data is a burden, but is change on the horizon?    

Factors like impending federal regulations, stricter enforcement of current policy and tech-fueled innovation are breaking down the roadblocks to interoperability. However, one of the most influential components driving this momentum is consumer expectations of a more modern, user-friendly healthcare system. This combination of influencers is changing a stagnant, often stubborn industry that has grown dependent on outdated technology and policy. 

Industry Anticipates New Rules on Interoperability and Patient Control of Data 

The Office of the National Coordinator for Health IT (ONC) recognizes that healthcare is strongly resistant to change. Entrenched industry interests and processes isolate and promote an environment that keeps data blocked and siloed. 

As the industry eagerly waits for ONC’s final information blocking rules to be released, many expect that patient access to medical data, or lack thereof, will drastically change over the coming months and year. Outdated institutional policies and antiquated technology that keep data in silos will be forced to give way to a more interoperable environment. 

The federal rules envision a more patient-centric healthcare environment and place emphasis on the adoption of common standards for exchanging information digitally to further reinforce patients’ ownership rights of their medical data. 

With Rules and Regulation Come Compliance

In lockstep with ONC’s proposed rules, the Office of Civil Rights (OCR), which oversees HIPAA compliance, is ramping up efforts to demand stricter enforcement of data sharing policy. In the last four months of 2019, OCR issued two corrective actions against healthcare organizations that failed to comply with the HIPAA Right of Access Initiative, which requires hospitals to provide patients with copies of their medical records promptly, in the form and format of the patients’ choosing, and without being overcharged. These corrective actions also came after an update to HIPAA guidance earlier in 2019 to reflect the growing adoption of mobile apps that can store and share health information. 

While HIPAA provides a foundation for data exchange, it has been poorly misinterpreted over the years, especially when it comes to sharing medical data with patients. Healthcare organizations often use HIPAA as a pretext for information blocking. However, proposed rules for improved patient access to their medical information, along with a closer eye on compliance, will result in consequences for provider organizations that continue to distort the rules, thereby creating barriers for patients such as requiring them to fill out multiple forms, wait an inordinate amount of time, pay exorbitant fees, or deliver them in irrelevant formats (e.g. CDs). Due to aggressive policy change and enforcement, an uptick in corrective actions as a result of patient complaints about difficulty obtaining their records is expected in 2020. 

The technology to support the easy, secure, HIPAA-compliant sharing of medical information through digital formats like cloud-based apps and patient portals is available (and expected by patients) but not widely adopted. Now is the time to consider innovating to digital formats to exchange patient information. Resources are available to integrate directly into physician workflows to support an easy transition and eliminate unnecessary or costly processes. 

Bring Health Tech into Today’s World

CDs are a technology of yesteryear. Most patients do not have the appropriate technology to read CDs, and, further, physical media is often plagued with issues like readability when shared with an outside facility, and inability to hold large files such as diagnostic images. Additionally, because they are physical and need to be manually couriered, they are often lost or broken. 

Technology has come a long way since the industry became reliant on CDs. Secure apps that comply with industry-specific standards such as Fast Healthcare Interoperability Resources (FHIR) provide flexibility and scalability for data exchange. Simple integrations within existing workflows and portals address the complexities in healthcare data exchange and interoperability that have previously impeded change. This technology allows providers to integrate separate forms of data like diagnostic imaging with clinical information in a clinical setting. Gone will be the days of separate platforms and logins to compile information on one patient. A streamlined and more effective workflow for clinicians creates a holistic picture for accurate patient care.  

Patient-facing applications are also becoming commonplace. These secure, HIPAA-compliant portals to exchange health information give patients ownership of their medical data throughout their healthcare journey, regardless of where they receive treatment. These cloud-based applications and integrated portals can and will replace the CD workflows that nearly 80% of providers still rely on. Healthcare organizations holding onto outdated processes should recognize that more relevant options for data exchange and patient access reduce administrative burdens and costs and can easily integrate into existing workflows. 

Prepare Now for Robust Data Exchange

Patients have a right to access their medical information with ease and simplicity; there is no way around that. The time is now for institutional commitment to discarding the old and embracing the new by adhering to new rules, complying with the updated policy, and implementing available technology. Failure to change negatively affects the patient experience and exacerbates roadblocks to care and access to data. Don’t wait until you’re headed down the road of corrective action enforced by a government entity to change. 

Cristin Gardner is Vice President of Product for Life Image.