In my journey through Draft Proposed Rule, I just came across another striking provision. CMS will require us to attest that we have actively supported interoperability, especially with physicians outside our own organization, and with technologies outside our own EHR.
The practicality of this provision will be exposed in FAQs and subsequent rulings - I don't think it is quite clear enough yet. The language of the proposed rule does not state whether simple Direct Messaging is enough, but could be interpreted to imply a requirement for actual interface to Health Exchanges, or to other provider's EHR. Those of us who have attested to interoperability in the past by simply connecting our own hospital to our own EP's might need to expand our connections.
Here are the three broad provisions. See the actual Three part Attestation in the Draft Proposed Rule, on Page 43:
- Provider did not disable functionality: First, the eligible clinician, EP, eligible hospital, or CAH would be required to attest that it did not knowingly and willfully take action (such as to disable functionality) to limit or restrict the compatibility or interoperability of certified EHR technology.
- Provider implemented technologies supporting exchange with unaffiliated providers: Second, the eligible clinician, EP, eligible hospital, or CAH would be required to attest that it implemented technologies, standards, policies, practices, and agreements reasonably calculated to ensure, to the greatest extent practicable and permitted by law, that the certified EHR technology was, at all relevant times: connected in accordance with applicable law; compliant with all standards applicable to the exchange of information, including the standards, implementation specifications, and certification criteria; implemented in a manner that allowed for timely access by patients to their electronic health information; (including the ability to view, download, and transmit this information) and implemented in a manner that allowed for the timely, secure, and trusted bi-directional exchange of structured electronic health information with other health care providers, including unaffiliated providers, and with disparate certified EHR technology and vendors.
- Provider responded to requests for information: Third, the eligible clinician, EP, eligible hospital, or CAH would be required to attest that it responded in good faith and in a timely manner to requests to retrieve or exchange electronic health information, including from patients, health care providers, and other persons, regardless of the requestor’s affiliation or technology vendor.