2018 saw many fascinating developments in health and human services, marking the efforts of communities across the nation as they continue to collaborate on innovative programs to coordinate care for high-risk and hard-to-reach populations, such as individuals who experience a combination of homelessness and substance use disorder. As the year comes to a close, we wanted to revisit some of the year’s most memorable developments and share what we see coming in 2019.
In this blog, we discuss the Patient-Centered Data Home (PCDH) initiative of the Strategic Health Information Exchange Collaborative (SHIEC). The purpose of this initiative is to facilitate data sharing with primary care providers, enabling patient data to be gathered from anywhere and then be shared through Health Information Exchanges nationwide. With this patient-centered focus, patient safety and outcomes get the highest priority, so that all pertinent data, such as allergies and adverse drug reactions recorded, can be stored in the patient’s record regardless of where the data was collected.
To confront the opioid epidemic facing the country, lawmakers passed HR 3545, or the Overdose Prevention and Patient Safety Act. The bill’s aim is to target two obstacles to helping patients suffering from opioid addiction—amending 42 CFR Part 2’s segregation of health and substance use disorder information, and simplifying the consent process—while seeking to maintain patient privacy. In our blog, we explored the law and some of the concerns surrounding its possible implications.
Other government initiatives to combat the opioid crisis include the Maternal Opioid Misuse (MOM) model aimed at removing and mitigating barriers to care coordination for expecting or postpartum mothers suffering from opioid use disorder, especially in rural areas where the crisis’ impacts are more strongly felt. This blog details the issues the MOM initiative was designed to resolve and highlights its goals.
The Extension for Community Health Outcomes (ECHO) is a program intended to improve care coordination in rural communities, following a model that connects rural physicians with large medical bodies or institutions. This blog details the impact this program has had both nationwide and internationally and explores how its hub-and-spoke model provides large-scale support to small-scale providers.
In the ongoing effort to improve data sharing and care coordination, the Office of the National Coordinator for Health Information Technology (ONC) has been working on a framework for encouraging medical innovation—especially regarding data exchange among healthcare providers. This framework, the Trusted Exchange Framework and Common Agreement (TEFCA), leans heavily on the establishment of Qualified Health Information Networks, which would work in concert to broaden data sharing and interoperability across larger networks. Our blog analyzed the pros and cons of TEFCA and set the stage for future discussions on how TEFCA might move forward to mitigate risks and challenges.
2019: What to Watch For
2019 promises to see the healthcare and social services landscape continue to evolve and come together. Emerging technologies such as artificial intelligence, predictive analytics, telemedicine, augmented reality, and virtual reality will be interesting to follow as they continue to unfold. There is one main theme that will affect all these developments: the ability to share patient data while ensuring security and privacy. With that said, here are three bills to keep an eye on in 2019:
In late 2016, the House passed the 21st Century Cures Act with the aim of accelerating the development and regulatory approval of medical innovations and data sharing. While most agree that data sharing is essential, there is still some uncertainty about what constitutes data blocking and the degree of severity. On September 17, 2018, the “ONC 21st Century Cures Act interoperability, information block, and the Health IT cert program” was submitted to address this issue.
To support goals of interoperability, as well as the vision of the 21st Century Cures Act, this rule proposes policy changes to move the healthcare industry toward a more accessible and interoperable healthcare ecosystem. Not many details about these policy changes have been released as yet, but the rule promises to help take the industry another step closer to true interoperability.
The federal government is looking to loosen the regulatory barriers to data sharing while maintaining patient privacy. The recent request for information (RFI) looks to “solicit the public’s views on whether there are provisions of the HIPAA Rules which present barriers that limit or discourage coordinated care and case management among hospitals, physicians (and other providers), payors, and patients, or otherwise impose regulatory burdens that may impede the transformation to value-based health care without providing commensurate privacy or security protections for patients’ protected health information and while maintaining patients’ ability to control the use or disclosure of their PHI and to access PHI.”
In addition, the RFI specifically seeks comments on the following issues:
- Methods of accounting of all disclosures of a patient’s protected health information
- Patients’ acknowledgment of receipt of a providers’ notice of privacy practices
- Creation of a safe harbor for good faith disclosures of PHI for purposes of care coordination or case management
- Disclosures of protected health information without a patient’s authorization for treatment, payment, and health care operations
- The minimum necessary standard/requirement
2018 has witnessed large strides towards true collaboration between providers across the health and social services spectrum, helping them come together to address issues such as homelessness, substance use disorder, and other chronic illnesses. As we move in 2019, the industry will build on that momentum and continue advancing through new legislation that helps put an individual’s healthcare needs and goals at the center of decision making, while still ensuring that patient security and privacy remains a top priority. We will continue to share updates as they are released. We hope you have a happy new year. See you in 2019!