The 21st Century Cures Act rules around interoperability and information blocking have been in effect for more than a month, but healthcare provider organizations are still facing challenges complying with them, or even understanding them. Many are leaning on their electronic health record vendors and even outside consultants for help.

WHY IT MATTERS
That's according to a new report from KLAS that surveyed a small sampling of health system execs to see how they're faring with the rules from the Office of the National Coordinator for Health IT, which took effect April 5.

Most of the 42 respondents reached by the research firm said they feel prepared for compliance with the information blocking rules.

"Given their greater access to legal and IT resources, larger organizations are the most likely to feel prepared – 91% of respondents from large organizations (>10 hospitals) say they are prepared or very prepared," according to KLAS. "Still, 12% of respondents do not feel ready, and an additional 17% aren’t certain one way or the other."

Some respondents cited the regs' "vagueness," which is "proving to be a bigger roadblock than actually implementing updated protocols and technology," researchers said. The lengthy final rule on info blocking is notable for eight key exceptions, for instance.

And while some providers say it's been a challenge to get their IT vendors to "address rules in a timely fashion" (certified EHR developers have their own set of Cures Act regulations to comply with), most say they're confident that they'll get the help they need, especially as those more stringent rules come online in October 2022.

Still, some "less confident customers worry that their vendor is taking too long to bring necessary functionality live," according to KLAS. "Several respondents report that they have had to develop workarounds in the meantime."

Of the small set of providers surveyed by the firm, their professed preparedness looks like this:

• Very prepared 21%.
• Prepared 50%.
• Neutral 17%.
• Unprepared 7%.
• Very unprepared 5%.

Of those facing the most challenges, common complaints included understanding what the rules require (46%), ensuring IT is compliant (20%), and making sure data governance strategies are compliant (15%).

Even so, a majority of respondents said they have "sufficient IT, clinical, and legal resources in-house to identify appropriate protocols" to ensure eventual compliance with the rules. Some are leaning on outside help, but most are relying on the support services from their IT vendor.

Most providers reported "replacing third-party solutions with additional modules" from their enterprise vendor, researchers said. "The next most commonly mentioned solutions are HIEs and other services that improve sharing with outside entities."

THE LARGER TREND
This isn't the only recent report showing lagging preparedness and lingering uncertainty about the info blocking rules.

In April, we reported on a Life Image survey that showed that "nearly half of respondents said they had either not made any changes or did not know how to ensure their facility met requirements."

In a recent interview with HIMSS TV, National Coordinator for Health IT Micky Tripathi conceded that more education and outreach were needed from ONC.

"As much as we're doing, more is needed for sure," he said. "One of the conversations we have with a lot of our partners – nonprofits, public-private collaborations as well as pure for-profit companies – is the need for educational outreach and the need for magnification of that message, as far as it can go."

But even when they understand them, the KLAS report suggests that some provider stakeholders are still skeptical about whether, or how much, the new rules will move the needle on interoperability.

Asked whether they think it will, 50% said yes – but 18% said no, and 32% said they weren't yet sure.

ON THE RECORD
"One of the main goals of these regulations is to make it easier for organizations to share [EHR] data specifically," said KLAS researchers. "However, even organizations that are confident in their own and in their [EHR] vendor’s preparation don’t necessarily feel confident the rules will reduce barriers to interoperability.

"Some who are uncertain say too many exceptions exist for the changes to be effective. Others say the current requirements are too focused on reducing barriers to patient access, and therefore won’t resolve technical barriers between vendors, which they see as the true hindrance to interoperability. Yet others express concern about potential negative repercussions of patients having access to all provider notes."

The report notes, however, "those who think the changes will accelerate interoperability point to the fact that those who aren’t in compliance risk being fined. They also cite confidence that the technology will mature as vendors are required to share."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.