The 21st Century Cures Act and Your EHR

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How Modernizing Medicine® Is Helping to Prepare Practice Teams for Upcoming Changes

Just like the E/M code changes of early 2021, the 21st Century Cures Act and the regulations promulgated thereunder will impact all of us in healthcare. Although requirements don’t go into effect until April 2021, at the earliest, with additional requirements rolling out gradually over the next couple of years, Modernizing Medicine® is already taking diligent and proactive steps with our IT development and clinical teams to ensure we are prepared, and that includes updates to the patient portal functionality of all of our speciality-specific EHR systems.

Whether your practice utilizes EMA®, gGastro® or any of the other products offered to our Dermatology, Gastroenterology, Ophthalmology, Orthopedics, Plastic Surgery, Otolaryngology, Urology, Pain Management and Podiatry communities, we are taking steps we believe are necessary to be prepared for the 21st Century Cures Act.

What is the 21st Century Cures Act?

The 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program is also known as the “Cures Act”. It was adopted into law on December 13, 2016, and the Office of the National Coordinator for Health Information Technology (“ONC”) issued final regulations implementing certain provisions of the Cures Act in May 2020 (the “Cures Act Final Rule”). The Cures Act Final Rule was modified by the Information Blocking and the ONC Health IT Certification Program: Extension of Compliance Dates and Timeframes in Response to the COVID-19 Public Health Emergency interim final rule (the “Cures Act Interim Final Rule”), which was released by ONC on October 29, 2020, and deferred many of the deadlines set forth in the Cures Act Final Rule in light of the ongoing COVID-19 Public Health Emergency.

The Cures Act and the Cures Act Final Rule include a wide range of requirements that will impact the Modernizing Medicine community, including updates to the certification requirements applicable to our certified EHR systems (“CEHRT”) and a prohibition on “information blocking” that applies to those defined as “Actors” under the rule, including developers of health IT like Modernizing Medicine and our healthcare provider clients.

What are the intended improvements of the Cures Act?

The Cures Act encompasses a wide range of intended improvements to the healthcare system, including:

  • Acceleration of research into preventing and curing illness and drug and medical device development
  • Efforts to address the opioid abuse crisis
  • Improvements to mental health service delivery
  • Updates to the Office of National Coordinator for Health Information Technology (“ONC”) Health IT Certification Program’s certification requirements
  • Improvements to interoperability of health information technology
  • Prohibition of information blocking

How could these changes affect my practice and Modernizing Medicine’s EHR solutions?

The final rule adopted by the ONC in connection with the Cures Act included two parts that are particularly relevant to the Modernizing Medicine community:

  1. New health IT standards, implementation specifications, certification criteria and requirements applicable to Modernizing Medicine and its products in connection with obtaining and maintaining our status as a certified electronic health record technology.
  2. A prohibition on activity defined as “information blocking” within the Cures Act Final Rule, which prohibition applies to “Actors” as defined in the rule, which includes Modernizing Medicine and our provider clients.

What is “information blocking”?

Information blocking has been defined by ONC as a “practice by a health IT developer of certified health IT, health information network, health information exchange, or health care provider that, except as required by law or specified by the Secretary of Health and Human Services as a reasonable and necessary activity, is likely to interfere with access, exchange or use of electronic health information (EHI).” (see, e.g., Information Blocking)

The Cures Act and the Cures Act Final Rule specify certain practices that could constitute information blocking, including, without limitation, the following:

  • Restrictions on access, exchange or use
  • Limiting or restricting interoperability
  • Impeding innovation and advancements in access, exchange or use of health IT-enabled care delivery
  • Rent-seeking or other opportunistic pricing practices; and•Non-standard implementation practices

How is EHI defined?

“EHI” means electronic health information and is defined to include:

  • From April 5, 2021, through October 5, 2022, the data elements represented in the USCDI standard; and
  • Starting October 6, 2022, all EHI in electronic medical records or other electronic designated record sets as defined by HIPAA.

What is the CMS Final Rule?

On the same date on which ONC adopted the Cures Act Final Rule, the Centers for Medicare & Medicaid Services (“CMS”) adopted the“Interoperability and Patient Access Final Rule” (the “CMS Final Rule”), which included related requirements intended to facilitate interoperability and patient access to health information, including the requirements that providers include digital contact information within their NPPES listing and requirements for hospitals related to admission, discharge, and transfer (or ADT) event notifications.

When is the Cures Act Final Rule taking effect?

As noted above, through the Cures Act Interim Final Rule, ONC, the agency responsible for issuing the Cures Act Final Rule, announced a deferral of certain compliance deadlines associated with the rule. For example, the information blocking and certain other provisions of the Cures Act Final Rule were scheduled to be effective as of November 2, 2020, but that timeline has been delayed until April 5, 2021.

What is Modernizing Medicine doing to comply with the Cures Act and the Cures Act Final Rule?

We are diligently working to implement updates that may be required to ensure that our systems are and remain current with applicable Cures Act and Cures Act Final Rule EHR certification and information blocking requirements. We are in the process of roadmapping all of the software updates that will be required to maintain certified status for our CEHRT consistent with the deadlines set forth in the Cures Act Final Rule, as updated via the Cures Act Interim Final Rule.

We have also reviewed our arrangements and practices for interoperability-related services to prepare them for compliance with the information blocking prohibition, to the extent applicable.

ONC Guidance for the Patient Portal—What does it mean for automatic posting of test results?

ONC guidance included in the preamble of the Cures Act Final Rule indicates that laboratory, pathology and similar test results should be made available to patients via their patient portal or a similar mechanism without delay.

The current version of Modernizing Medicine’s EHRs permit you to push documents to the portal upon receipt by ensuring that they are actively monitoring the results queue and promptly signing and pushing such results to the portal. We are currently working to finalize plans for additional development work that would, in a more automated fashion, enable our clients to make results available to their patients on a timeline that they believe meets their compliance obligations while balancing any concerns the impacted providers may have related to making certain test results available to their patients automatically without prior explanation, consultation or context with the patient. Stay tuned for more detailed information and a timeline of availability as soon as we have it.

When can your practice expect to see changes in our EHR to comply with the Cares Act?

We expect much of the requested and required functionality to be available over the course of 2021, with some of the larger items, including, for example, the EHI export functionality, to stretch out into 2022 and 2023 in accordance with the applicable regulatory deadlines. We will provide specific communications to our clients related to the availability of these exciting changes.

What is Modernizing Medicine doing to identify additional opportunities for your practice to connect with the larger healthcare ecosystem?

We recognize that ONC, CMS and other government agencies have prioritized interoperability and the ability of patients and providers to have more seamless access to health information. In pursuit of that stated goal, we continue to develop both our technology and our business processes to help you connect with other third-parties to support your provision of care to your patients and the efficient operation of your medical practice.

For example, we recently announced our modmed® synapSYS program which is intended to gather in one place all of our program elements related to the work we have done to facilitate connections to and within the larger healthcare ecosystem. We likewise maintain interfaces and other connections with many other actors in the health care environment and add to the list nearly every day. We encourage you to monitor our websites and stay up to date on the list of healthcare and healthcare-related companies with whom we maintain a relationship.

What else can my practice do to get ready for the Cures Act?

Your practice’s EHI provision policies may need to be updated, so now is an excellent time to review them, make any revisions and discuss any changes with your practice team. It’s also important for your team to know how to respond to requests for information, and it is recommended that you also provide these updates with your patients.

Since healthcare regulations are continually evolving, it’s vitally important for your practice to partner with an EHR solution that is committed to proactivity and compliance with any regulatory legislation, including the Cures Act.

Discover why your colleagues are choosing to entrust Modernizing Medicine to keep their EHR ahead of the curve.

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