Delays to Information Blocking and Health IT Certification in 21st Century Cures Act Final Rule

The big news in the world of Health IT today is ONC’s announcement of the Cures Act Final rule which includes some delays to the information blocking and health IT certification requirements.  These delays are an update to the Cures Act Enforcement Discretion that was announced back in April.  You can check out the full Cures Act Final rule on the Federal Register.

For those mostly interested in the Cures Act delays, here’s a summary of the new compliance dates and timelines that are in the Cures Act Final rule:

Response from the health IT community has been largely positive and appreciative of the delays.  There’s an acknowledgment of the impact COVID-19 has had on healthcare organizations and that a delay was helpful to many organizations.  Although, some thought some of the delays were unnecessary.  Here’s a few responses to the delays and final rule from those in the industry.

ONC’s national coordinator for health IT, Don Rucker, MD said:

We are hearing that while there is strong support for advancing patient access and clinician coordination through the provisions in the final rule, stakeholders also must manage the needs being experienced during the current pandemic. To be clear, ONC is not removing the requirements advancing patient access to their health information that are outlined in the Cures Act Final Rule. Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on COVID-19 response.

Anders Gilberg, Senior Vice President, Government Affairs from MGMA shared the following:

The five months of additional time afforded by the agency is critical for medical practices as they face significant operational and financial challenges associated with the national COVID-19 pandemic. MGMA maintains its concern that the information blocking regulation, with its many complex and confusing requirements and exceptions, will add unnecessary administrative burden on medical groups. We urge ONC to take full advantage of this additional time and develop comprehensive guidance and targeted educational resources.

Wylecia Wiggs Harris, PhD, CAE, Chief Executive Officer at AHIMA said:

The rule was scheduled to go into effect on November 2, but ONC has delayed this compliance deadline until April 5, 2021. We feel this is a prudent decision, as the reallocation of resources due to the COVID-19 pandemic has made it challenging for many health information professionals to ensure their institutions are sufficiently in compliance by November 2.

Ensuring that patients have seamless, timely, electronic access to their health information regardless of where that information travels will continue to be a top priority for health information professionals. The five-month delay allows them additional time to see that their institutions’ policies and procedures are in place to fully enable the access, exchange, and use of electronic health information. We thank ONC for being cognizant of the realities health information professionals are encountering during the COVID-19 pandemic.

Ben Moscovitch from Pew offered this comment:


He received a lot of support for this comment and many agreeing it was an unnecessary delay.

Then, he offered this perspective:

Dr. Emad Rizk, Chairman, President and CEO at Cotiviti shared this:

The pandemic has magnified healthcare’s struggles with interoperability, but it has also provided a learning opportunity and highlighted how powerful data can be. The ONC rules lay the foundation for greater interoperability by requiring seamless access and exchange, but despite the delay in rule compliance there are actions healthcare organizations can – and should – take now to improve interoperability in the industry. Payers and providers can look to advanced analytics in order to gain actionable insights that will move the needle on collective efforts to improve costs and quality of care. An example of this is a single patient identifier which would have proven invaluable in identifying high risk populations proactively in the current pandemic. At Cotiviti, we leverage single patient identifiers in our COVID-19 tracker to identify syndromic patients prior to break outs. By improving alignment among providers and payers, interoperability can encourage an industry-wide shift towards more personalized, continuous, and proactive care, which can optimize quality and cost performance in a value-based care world.

Self proclaimed Health IT Policy Nerd, Genevieve Morris, captured the sentiment of most really nicely:

Brendan Keeler seems to agree:

Drew Ivan, Chief Product and Strategy Officer, and Austin Dobson, Product Manager from Lyniate said:

The deadline extensions will be welcomed news and a huge relief to almost everyone who has to comply with them. A lot of providers and vendors were preparing to embark on projects to implement solutions for the ONC rules when COVID hit with full force, resulting in the need to pivot and re-direct their focus to respond to the pandemic instead. This has necessitated changes to clinical and business processes, as well as rapid scaling of their technological capabilities, including their telehealth solutions. Additionally, general productivity took a hit when much of today’s workforce transitioned to working from home.

The full list of requirements and deadlines was already confusing, so it is a concern that hastily rolling out changes will make the situation worse. ONC has an opportunity here to help providers and vendors alike with clear communications. They need to move forward with direct, substantive direction in order to facilitate patient access to healthcare data and connected systems, which matter now more than ever.

Dr. Chris Hobson, Chief Medical Officer at Orion Health offered this perspective:

COVID-19 is putting added pressure on the healthcare industry, and coupled with the complexity and importance of these rules, the extra time to comply is greatly appreciated, but shouldn’t be viewed as a reprieve from the work needing to be done to ensure compliance. Instead, the delay offers a great opportunity for providers, payers and vendors to work together to achieve the goal of increase transparency, clarity and standardization around the rules. Use the extra time to make the most of your effort to comply with the rules and embrace the upcoming changes. The rules aren’t going away and instead are long-term drivers organizations should be building strategies around. Work towards complying sooner rather than later to ensure your organization is prepared when they finally come into effect.

What do you think of the delays to the information blocking rule? Do you think they’re a good idea or should they have pushed forward? Are there other changes in the final rule that stood out to you? Regardless of the delays, healthcare organizations should still be preparing now. This isn’t just something you switch on overnight.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • Drew Ivan is absolutely correct. I hope ONC also takes advantage of this delay to provide useful guidance to vendors and providers. We should not need to read between the lines or try to make sense of hundreds of pages of a rule to try and find answers. There are still so many unanswered questions and confusion surrounding some of these requirements.

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