Information-blocking rule in 21st Century Cures Act redefines data exchange in healthcare

A Verato survey offers perspectives on the data management strategies of healthcare executives, highlighting the crucial role of Healthcare Master Data Management (hMDM) in addressing key gaps, facilitating seamless data exchange, and aligning with the mandates of the 21st Century Cures Act.

Critically, while 61% of surveyed organizations have invested effort and resources into meeting the requirements of the Cures Act, only 36% report having the necessary comprehensive data quality programs in place to do so.

The 21st Century Cures Act set standards for the secure and frictionless exchange of data among payers, providers and consumers, including the establishment of an information-blocking rule that was finalized earlier this year.

Recently, the U.S. Department of Health and Human Services (HHS) released a new proposed rule to establish information blocking disincentives for hospitals and health systems. Under the rule, if the HHS Office of Inspector General (OIG) determines an eligible hospital has participated in information blocking, that organization may be limited for incentives through the Medicare Promoting Interoperability Program, the Quality Payment Program and the Medicare Shared Savings Program.

Only 41% of respondents report being able to completely comply with the info-blocking rules set forth in the Cures Act.

When asked about their readiness for specific provisions of the Cures Act, fewer than half of respondents said their organizations are fully compliant in these key areas:

• Sending electronic notifications of patient activity to other healthcare organizations (44%)
• Obtaining patient consent and authorization to share their data with external sources (46%)
• Maintaining technical infrastructure that ensures secure information exchange (43%)
• Sharing patient-level information with patients, other healthcare organizations and systems (43%)
• Receive patient-level information from other healthcare organizations and systems (43%)

“With the new proposed rule outlining disincentives, the pressure is on for hospitals and health systems to invest in the right data infrastructure,” says Clay Ritchey, CEO of Verato.

“The information blocking rules in the 21st Century Cures Act will also significantly raise the amount of data that flows between organizations within the healthcare industry. If executives aren’t confident in their technical ability to handle this influx, we encourage them to start taking the necessary steps now,” Ritchey continued.

98% of healthcare executives expect an increase in data requests from other organizations, and 97% predict an increase in data coming into their organization from external sources. With this influx of data, 57% believe that patient data-matching errors will result in a healthcare crisis within the next five to 10 years.

Two thirds of healthcare organizations are not completely confident in their data management infrastructure’s ability to protect the integrity of patient data. 49% report that their data is still stored in fragmented, siloed systems.

97% see future negative impacts of poor data management as the amount of data coming into their organization increases—including poor patient outcomes, deterioration in care quality and more difficult billing.

89% agree that an MDM/hMDM system is required to manage the increase in data captured in different systems. The use of an hMDM system to properly identify patients and accurately match and master their data is a foundational element of health data exchange, yet it still presents a challenge for many organizations.

According to AHIMA, the prevalence of duplicate records in most hospitals is upwards of 10%, but in health systems with multiple facilities that rate is closer to 20%.

Ritchey continues: “At Verato we believe that, beyond meeting compliance and avoiding disincentives, an hMDM is the bedrock of any organization’s data infrastructure. As the industry continues to embrace these interoperability requirements, it’s becoming increasingly important that healthcare organizations be able to confidently know who is who and provide complete, clean, trusted data that’s ready to share with consumers and other organizations.”