ASCO has highlighted the concerns surrounding the persistent lack of interoperability of electronic medical records (EMRs) and the challenges it poses to cancer care to the Senate Health, Education, Labor & Pensions (HELP) Committee. The Society recently submitted a letter from President Monica M. Bertagnolli, MD, FACS, FASCO to Committee Chairman Lamar Alexander (TN) and Ranking Member Patty Murray (WA), in response to the March 26, 2019 hearing focused on “Implementing the 21st Century Cures Act: Making Electronic Health Information Available to Patients and Providers.”
The 21st Century Cures Act is instrumental in efforts to improve care coordination and information sharing, as it addresses some of the technical limitations and business practices that may contribute to the current limitations of true interoperability. In its letter, ASCO addressed in general two proposed rules: one from the Department of Health and Human Services (HHS), Office of the National Coordinator for Health Information Technology (ONC) titled, “21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program,” and a companion proposed rule from the Centers for Medicare & Medicaid Services’ (CMS) addressing interoperability and patient access to electronic health information in programs under their authority.
ASCO noted that these two proposed rules place strong emphasis on the availability and widespread use of application programming interfaces (APIs) for exchange of and access to electronic health information; place special focus on patients’ access to their electronic health information; and when finalized will impact all stakeholders in the healthcare system.
ASCO also noted that it will be submitting more detailed comments in response to the proposed rule, and cautioned lawmakers that in particular the exceptions to information blocking proposed in the ONC rule need to be monitored to discourage exploitation of these exceptions as a mechanism to obstruct free data flow.
In addition to the two proposed rules, ASCO recognized two recent ONC efforts: 1) the “US Core Data for Interoperability (USCDI),” which specifies a common set of health care record data classes required for health data interoperable exchange, and 2) the Draft Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. ASCO is currently developing a set of “Minimal Common Oncology Data Elements” (mCODE™), under its CancerLinQ subsidiary, which the Society believes could align with ONC’s USCDI efforts.
The mCODE set of data elements is envisioned by ASCO to form the basis of an initial parsimonious set of necessary data that should populate all electronic health records (EHRs) serving patients with cancer. Adoption of these data elements, which are being developed by experts in the fields of oncology and informatics, would greatly streamline the exchange of basic needed data necessary for oncologists. The National Cancer Institute (NCI) is engaged with this project, and ASCO looks forward to collaborating with ONC wherever possible to encourage consideration and adoption of these elements when they are finalized.
Lastly, the Society also praised ONC’s efforts to support enhancements to prescription drug monitoring program (PDMP) integration as a priority use case for standards-based health IT solutions.
ASCO commends the HELP Committee for its leadership and bipartisan work on this issue. The Society looks forward to continuing to work with the Committee as the implementation of the Cures Act and the rules governing HIT use and development continues.
In December of last year, the House Energy and Commerce Committee held a similar hearing on the implementation of the Health IT provisions in Cures. This hearing was held prior to the release of the two rules by ONC and CMS. ASCO applauds the bipartisan, bicameral efforts to ensure improved interoperability and prohibit information blocking.
Read the March 2019 letter to the Senate HELP Committee.
Read the December 2018 letter to the House Energy & Commerce Committee.
