The Department of Health and Human Services has issued a request for information as it considers policy moves to further accelerate interoperability and health information exchange beyond initiatives previously launched under the Office of the National Coordinator for Health Information Technology.

Comments due by April 21. Adoption of basic electronic health records systems has steadily risen under the meaningful use program. An estimated 40 percent of physicians were using the software in 2012, and HHS expects that to top 50 percent during 2013. Now, the goal is to accelerate health information exchange.

“We seek to build on that work by engaging other policy areas within HHS jurisdiction to promote routine sharing of information among health care providers across settings of care to support care coordination and delivery system reform,” the department notes in the RFI. “We also recognize that economic and regulatory barriers may impair the development of a patient centered, information rich, high performance health care system where persons’ health information follows them wherever they access health care services.”

That means moving beyond acute care hospitals and physician practices to other care settings. Under fee-for-service, many providers and software vendors still do not have a business imperative to share health information, HHS contends. Consequently, EHR remains very low in long-term, rehabilitation and psychiatric hospitals.

The RFI details potential options to accelerate HIE progress, including:

  • Expand states’ authority to rely less on traditional Medicaid forms of payment, which would encourage HIE, and remove other state-level regulatory barriers to data exchange;
  • Expand HIE requirements for new ACO, bundled payments and primary care programs; and
  • Develop new measures of care coordination that encourage records sharing during care transitions in meaningful use and quality reporting programs.


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