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Interoperability rules won't succeed without the CIO

COVID-19 is the crisis at hand, but healthcare CIOs also have to work on complying with new interoperability rules finalized last month.

The coronavirus pandemic has effectively erased newly finalized interoperability rules from the health IT headlines. Despite rumors, there has been no word from the U.S. Department of Health and Human Services about delaying enforcement of the final interoperability and information blocking rule from ONC and the supplemental patient access rule from CMS.

Yet the agency is keeping the current crisis in mind.

"HHS's top priority is protecting the health and well-being of all Americans," an HHS spokesperson said in a statement to SearchHealthIT. "In light of the coronavirus disease 2019 (COVID-19) outbreak, HHS is assessing all its policies across all its programs to strengthen our response and ensure the success of a whole-of-America approach in combatting COVID-19."

The COVID-19 crisis is still underway, but healthcare CIOs should also be thinking about how to implement the ONC and CMS interoperability rule requirements. During interviews conducted in mid-March, healthcare CIOs Michael Archuleta and Aaron Miri, as well as Gartner analyst Sharon Hakkennes, highlighted three ways CIOs can get started.

1. Build an interoperability strategy

If a CIO doesn't already have an interoperability strategy for their healthcare organization, it's time to build one, said Hakkennes, a former healthcare CIO who is now with Gartner's healthcare consultancy practice.

Sharon HakkennesSharon Hakkennes

Hakkennes said it's important for CIOs to have a strategic approach to interoperability because the rules from federal regulators touch on so many areas, which include providing patients access to their own data as well as sharing health data with other healthcare systems. When crafting an interoperability strategy, CIOs will need to make compliance a priority and should focus on partnerships with in-house staff and external vendors if they want to succeed. They will also need to evaluate their data access and patient consent policies as part of their overall interoperability strategy.

Having a broad, organization-wide view of interoperability and setting goals will help keep the organization on the right path, she said.

"This needs to be a strategic approach from our CIOs," she said. "It will depend on where they're at with their interoperability at the moment and how much they need to start their planning for building out an interoperability strategy, or how they review and amend their interoperability strategy in line with these new requirements."

2. Focus on EHR vendor partnerships

Hakkennes said CIOs will also need to work closely with their EHR vendor to understand the timelines federal regulators laid out for complying with the new interoperability rules, as well as how their EHR vendors are going to approach those requirements.

For example, CIOs should press EHR vendors on how they plan to comply with ONC's requirement that health systems implement APIs so patients can access their health data from an app of their choosing. Healthcare systems will be mandated to use Fast Healthcare Interoperability Resources (FHIR)-based APIs within the next 24 months. FHIR is an interoperability standard for exchanging electronic health information (EHI).

Michael ArchuletaMichael Archuleta

Archuleta, CIO at Mt. San Rafael Hospital in Trinidad, Colo., echoed the importance of the CIO-EHR vendor relationship. He suggested CIOs focus on how the interoperability rules define EHI as well as the healthcare system EHR's ability to export EHI for patients upon request, which the rules require within the next 24 months. It will be critical for CIOs and EHR vendors to be on the same page in order to comply with the federal regulations, he said.

Hakkennes said an EHR vendor's actions to comply with the requirements should happen in sync with the CIO's overall interoperability strategy.

"It's imperative for the future that the vendor supports [CIOs'] strategic approach to interoperability," she said.

3. Make it a group effort

Miri, CIO at Dell Medical School and UT Health Austin in Texas, said complying with the interoperability rules should be a group effort.

Aaron MiriAaron Miri

After taking time to understand and digest the interoperability rules, Miri said CIOs should make it a point to explain them to medical staff, faculty, and clinical leaders, even if that means putting on the hat of salesperson. He said CIOs can help staff understand how the rules will improve workflows, what the expectations are and why the interoperability rules are important for patients.

This has to be a partnership. It's our job as IT leaders to empower our clinicians, our frontline staff, to be successful.
Aaron MiriCIO, Dell Medical School and UT Health Austin

"You can't do it alone," he said. "This has to be a partnership. It's our job as IT leaders to empower our clinicians, our frontline staff, to be successful. These rules don't mean anything unless they understand why it's important for them and why it translates to better patient care."

Indeed, Hakkennes said the CIO will play an integral role in bringing together IT and clinical staff to figure out the impacts of the interoperability rules, to explain what the healthcare system will be required to do, and to ensure the healthcare organization protects patient privacy and security as data sharing increases.

Next Steps

COVID-19 delays enforcement of federal interoperability rules

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