Information Blocking Guidance to the Health IT Community

Gain Actionable Implementation Guidance and Feedback

In May 2019, a Phase 1 deliverable was released with formal comments on the U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology’s (ONC) Proposed Rule on implementation of provisions of the 21st Century Cures legislation. A Phase 2 deliverable, focused on the implementation and implications of the ONC’s Proposed Rule and potential outcomes, is now available. The full report includes a complete summary of discussions and observations from Workgroup members.

In advance of the publication of U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) final information blocking rules, The Sequoia Project has released “Guidance to the Community and Implementation Feedback to HHS.” The guidance was developed by a cross-industry Information Blocking Workgroup formed to provide input into The Sequoia Project’s comments to the ONC on the proposed rules, identify practical implications of proposed and final information blocking rules, and facilitate discussions to clarify information blocking policies before and after the Final Rule.

“Given the broad and significant impact the rules would have to the health information sharing community, we formed the Information Blocking Workgroup. Working collaboratively to interpret and apply the rules will be important to fostering cooperation as the community prepares for ONC and OIG [Office of Inspector General] enforcement,” said Mariann Yeager, CEO of The Sequoia Project.

The Work Group addressed implementation-related aspects of priority components of the information blocking regulation, including:

  • Regulatory Definitions (e.g., Health Information Exchange and Health Information Network);
  • Information Blocking Practices;
  • Recovering Costs/Licensing Exceptions; and
  • Compliance Plans and Implementation Plans.

 

The Workgroup consists of engaged experts, regardless of The Sequoia Project membership. Co-Chairs David Camitta, of SpiritHealth, and Paul Uhrig, of Surescripts, led the workgroup with the support of co-facilitators Mark Segal, of Digital Health Policy Advisors, and Steve Gravely, of Gravely Group. Representatives from diverse sectors of health information technology were included in the workgroup, including:

  • Associations and organizations in the health IT community;
  • Consumer organizations;
  • Federal government agencies;
  • Health information networks and service providers;
  • Healthcare providers and physicians;
  • Legal, technology, standards, and policy subject matter experts;
  • Payer organizations;
  • Public health organizations;
  • Health IT vendors;
  • Informatics organizations;
  • Safety net providers and service providers; and
  • Release of information companies.

    Download the Information Blocking Guidance to the Health IT Community Published

    A previous Phase 1 deliverable of the workgroup was provided to the ONC in May 2019 as formal comments on ONC’s Proposed Rule implementing provisions of the 21st Century Cures legislation, including information blocking. Today’s guidance is considered a Phase 2 deliverable, focused on implementation and implications of the ONC’s proposed rules and potential outcomes. During Phase 3, which began in January 2020, the Work Group will review the Final Rule and identify and address priority implementation topics and approaches.

    “This report aims to be a guide for the community. Implementation guidance is essential to reduce uncertainty and prepare for compliance.”

    Mariann Yeager, CEO, The Sequoia Project

    Associations and Orgs – Health IT Community
    – Anne Kimbol, HITRUST Alliance
    – Mari Greenberger, HIMSS
    – Lauren Riplinger, AHIMA
    – Scott Stuewe, DirectTrust
    – Samantha Burch, AHA

    Consumers
    – Ryan Howells, CARIN Alliance
    – Deven McGraw, Ciitizen

    Consultant
    – Brian Ahier, MITRE Corporation

    Federal Government
    – Steve Bounds, SSA

    Health Information Networks and Service Providers
    – Angie Bass, Missouri Health Connect
    – Dave Cassel, Carequality
    – Laura Danielson, Indiana Health Information Exchange
    – Paul Uhrig, Surescripts, Co-Chair

    Health Providers/Physicians
    – David Camitta, CommonSpirit, Co-Chair
    – Eric Liederman, Kaiser Permanente
    – Matt Reid, AMA
    – Mari Savickis, CHIME

     

    Legal, Technology, Standards, and Policy Subject Matter Experts
    – Josh Mandel, Microsoft
    – Micky Tripathi, MaEHC

    Payers
    – Nancy Beavin, Humana
    – Danielle Lloyd, AHIP
    – Matthew Schuller, BCBSA

    Vendors
    – Aashima Gupta, Google
    – Cherie Holmes-Henry, EHRA/NEXTGEN
    – Rob Klootwyk, Epic
    – Josh Mast, Cerner

    Public Health
    – John Loonsk, APHL

    Informatics
    – Jeff Smith, AMIA

    Safety Net Providers/Service Provider
    – Jennifer Stoll, OCHIN

    Release of Information Company
    – Rita Bowen, MROCorp

    March 14, 2019
    Information Blocking Workgroup Meeting
    Agenda: Interoperability Matters Overview, Information Blocking Proposed Rule: Overview and Workgroup Scope

    March 19, 2019
    Information Blocking & You – Public Advisory Forum
    Slides | Recording

    March 25, 2019 – 12:30 p.m. ET
    Information Blocking Workgroup Meeting                                               
    Agenda: Actors & Others Definitions (Providers, CEHRT Developers, HIEs, HINs), Information Blocking Practice, Exceptions 1-3 (Harm, Privacy, Security)

    March 29, 2019 – 12:00 p.m. ET
    Interoperability Matters Leadership Council

    April 3, 2019 – 1:00 p.m.
    Information Blocking Workgroup Meeting                                        
    Agenda: Exceptions 4-7 (Recovering costs reasonably incurred, Declining to provide access, exchange, or use of EHI if request is infeasible, Licensing technologies or other interoperable elements, Making health IT unavailable to perform maintenance or improvements), Conditions & Maintenance of Certification: Information Blocking, RFIs: disincentives for providers and price transparency, Complaints & Enforcement

    April 5, 2019
    Public Advisory Forum
    Slides | Recording

    April 15, 2019
    Joint Information Blocking Workgroup Meeting &
    Public Advisory Forum Call #3 to Review Draft Report
    Slides | Recording

    April 22, 2019 – 12:00 p.m. ET
    Interoperability Matters Leadership Council

    May 23, 2019 – 1:00 p.m. ET
    Public Advisory Forum – Cancelled

    May 31, 2019 – 1:00 p.m. ET
    Interoperability Matters Leadership Council

    June 20, 2019 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting
    Agenda: Phase I Update: Review CMS & ONC Comments & Phase II: Proposed Workplan

    July 30, 2019 – 2:00-3:00 p.m. ET
    Interoperability Leadership Council

    August 2, 2019 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting
    Agenda: HIE/HIN Definitions

    August 21, 2019 – 5:15 p.m. ET (Washington, DC)
    Joint Leadership Council #6 & Information Blocking Workgroup Meeting and Networking Reception
    Agenda: Information Blocking Workgroup; Update Interoperability Matters Prioritization; and Member Resources

    September 6, 2019 – 1:00 p.m. ET
    Interoperability Matters Public Advisory Forum
    Slides

    September 13, 2019 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting
    Information Blocking Practices

    October 11, 2019 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting
    Agenda: Recovering Costs/RAND Licensing

    October 18, 2019 – 12:00 p.m. ET
    Leadership Council 
    Agenda: RCE, Proposed Workgroups

    November 1, 2019 – 1:00 p.m. ET
    Public Advisory Forum
    Agenda: Information Blocking, TEFCA
    Slides

    November 8, 2019 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting
    Agenda: Compliance Plans

    December 13, 2019 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    December 16, 2019 – 2:00 p.m. ET
    Public Advisory Forum
    Agenda: Information Blocking, TEFCA
    Slides

    January 10, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting                                               
    Agenda: Phase II Deliverable Status, Implementation planning – Phase III Initial Work

    February 14, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting – Cancelled

    March 20, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    April 10, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    May 8, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    June 12, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    July 10, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    August 14, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    September 11, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    October 9, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    November 13, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting

    December 11, 2020 – 12:00 p.m. ET
    Information Blocking Workgroup Meeting