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3 Final Rule Implications for Providers Going Into Effect in 2021

Exponential Health for Providers and the Final Rule

ONC’s Final Rule is going into effect this year. Here are the three big changes Providers will need to anticipate.

Hey Providers, remember that Final Rule you were all so thoroughly prepared for last year? But then that global pandemic came through and messed up all your well-laid plans? Well. It’s back! The ONC adjusted its timeframes, and various parts of the Final Rule will go into effect over the next 12 months.

Last week, I explored the impact for Payers, but this week, it’s all about YOU, fair Provider. In this post, we’ll explore three critical implications of the Rule and how they will impact your organizations:

  1. Public Reporting and Information Blocking 
  2. Admission, Discharge, and Transfer Event Notifications
  3. Digital Contact Information

Let’s dive in.

Public Reporting and Information Blocking

The Rule’s intention is to push the industry to crack-down on information blocking and encourage public health reporting. 

What does that actually mean for Providers?

Exponential Health

Hospitals and clinicians will need to attest to Promoting Interoperability Program (PIP) requirements that help patients access their health information electronically. (PSA: There are eight exceptions to the requirements that are not considered information-blocking—I won’t detail them all in this column, but you can find all the details here).  

To meet these requirements, organizations will need to build a digital framework that supports the secure exchange of information between Providers at the patient’s request. This stipulation aims to promote population health, care coordination, and reporting on the social determinants of health.  

Admission, Discharge, and Transfer Event Notifications

To improve care coordination, CMS Conditions of Participation now require hospitals to send event notifications of patient admission, discharge, and transfer to other practitioners managing the patient’s care. These notifications will synchronize care delivery across the patient’s various practitioners. This harmonization will be a game-changer for patients with chronic illnesses so their care team will all be on the same page, which will improve patient safety and well-being. 

Meeting this requirement will require hospitals to build out a digital infrastructure for robust data sharing. If you see a theme here, you’re very astute! Hospitals, you need to update your infrastructure. (Obv, I know of a certain code-free platform that would be ideal.)

Digital Contact Information

Similar to the previous rule-changes we’ve explored, Providers will need to list and update their digital contact information in the National Plan and Provider Enumeration System (NPPES). Compliance means exposing your FHIR or other endpoints to support the access and transmission of electronic health information (EHI). 

To meet this requirement, Provider organizations will need to create or update their current endpoints. This change is important to consider because many existing Providers are operating on HL7 and will need to upgrade to FHIR and/or other approved API frameworks for sharing healthcare information. 

Some organizations will need to take on a significant transformation initiative to prepare their digital infrastructures to meet these needs. 

The Final Rule may have been designed to promote care coordination via the unimpeded flow of digital information, but Providers should view it as an opportunity to modernize their operations and take advantage of new technologies 

To learn more about the nexus of healthcare and technology, check out other recent entries in Exponential Health or email Olya

About the Author

For the better part of a decade, Olya Ossi has focused on digital transformation and innovation in healthcare. Prior to Unqork, Olya was the head of operations at a healthcare technology consulting firm, serving as general manager and consultant for clients in the healthcare, government, and nonprofit sectors.

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