History of Healthcare Technology Regulations: What You Need to Know

2 minute read

Healthcare is one of the most highly regulated industries in this country, and rightly so, since people’s lives are the focus of healthcare. Over the past couple of decades, healthcare technology has taken center stage, to help providers ensure they are delivering the best level of care.

Let’s look back at how healthcare technology became a focus of more regulations. Post HIPAA, in 2009, the Obama administration launched the Health Information Technology for Economic and Clinical Health Act (HITECH). I know that’s a mouthful as many of our acronyms in healthcare are. This law not only updated HIPAA, but also included a significant amount of funding to promote healthcare technology and support the CMS triple aim: better health outcomes; lower costs; and better patient experience – we have now added a fourth aim to include better provider experience.

Since that time, we have witnessed many advancements coming from new and innovative technologies, some driven by the regulations and supporting providers that have to comply. Most notable is the acceleration of the adoption of EHRs.

In 2009, when EHR incentives were put in place, the desire was to get providers off of paper-based patient files. We did that and more. Now with digital data, we can do comparative effectiveness analysis, population health, and predictive analytics on sicker populations. Fast forward to today and we know that digital transformation holds the promise for many advancements in patient care. With that comes more regulations and how that data sharing can be used effectively.

The most comprehensive healthcare technology law since Affordable Care Act (ACA) and HITECH is the 21st Century Cures Act. A bipartisan regulation signed into law in 2016 that advances data sharing and the usefulness of digital data.

Since that time, and over the last seven years, more rule making has taken place as components of the law start to take effect. Most notably is the information blocking law that requires all data be shared with critical stakeholders including patients.

Let’s look at one such rule in a proposal state right now: The Advancing Interoperability and Prior Authorizations Rule:

The Advancing Interoperability proposed rule is supporting a FHIR framework, which puts much of the regulation on payers to support the exchange of information and enhance workflow. That said, however, providers will have to be able to digest data in formats they may not be supporting today.

CMS is promoting a FHIR based standard for sharing information.

FHIR (Fast Healthcare Interoperability Resource) is an advancement from HL7 that provides for a richer set of data based on FHIR resources. Healthcare IT systems often don’t share the same data models. As healthcare data becomes more digitized, solving incompatibilities between different systems becomes expensive and time-consuming. FHIR defines a common data model and REST architecture so that different healthcare systems can share and integrate data. FHIR uses these resources to represent discrete medical, administrative, infrastructural, or financial data elements.

Providers will push the requirements to support FHIR onto the vendors they work with. That’s where Consensus Cloud Solutions can help. We can take a digital fax document, a scanned document or any unstructured document and convert that into a FHIR message. So that systems’ can send a fax and we will convert it to FHIR or the other way around from FHIR to a fax. If advanced health systems are supporting FHIR, but some of their post-acute providers can’t digest or query FHIR, we can convert the message to a fax message to continue the continuity of care.

Yes, and it may grow even more important as we are moving from unstructured documents (fax), to a structured format. That can be shared as a C-CDA or the USCDI data set. It is not necessary to change what you have today. Consensus can ensure you take advantage of the advancements and we will meet you at your current level of digital transformation

What we can promote is getting off of paper fax machines. In that context none of these advancements can be experienced. We need to push providers and administrators to move to a digital cloud fax solution. From there, so much more important and timely data can be shared. That can lead to better and faster patient care.

Remember the EHR incentives? When we added quality measures for using that technology meaningfully, we saw great strides in measuring care improvement. With this advancement, we can measure this through quality metrics from providers to health systems. Compensation from CMS depends on these qualifiable better health outcomes. The next challenge today is to reduce the burden of the reporting and data entry required. Much of these measures are tracked in EHRs. We know many care settings were not given the incentives to implement an EHR, which challenges organizations like SNFs, assisted living, home health and hospice care.

Digesting these new rules and what it means to you can be confusing whether you have an EHR or not. Consensus is dedicated to advocating with our lawmakers at events and in DC so that we can ensure these rules take into account many post-acute care settings and how we can provide equitable access to these new technologies.

I will continue to provide insights into new and proposed rules. As always, your feedback is important to us as we want to represent our customers and any of your comments or concerns. You can email me at [email protected] to share your thoughts.