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The healthcare sector is about to undergo a significant shift. The HTI-2 proposed rule is at the heart of this change. This rule is an important regulatory development, directly impacting public health data sharing and interoperability. Understanding the HTI-2 proposed rule is crucial for healthcare organizations. It’s not just about compliance. It’s about leveraging health tech to improve patient outcomes.

In this blog, we’ll delve into HTI-2’s implications for data privacy, health analytics, and Electronic Health Records (EHR) systems and provide guidance for public health professionals. Navigating the transition to new systems can be challenging, but we’re here to help. Join us as we explore this major shift in public health data sharing. Let’s embrace the path to interoperability together.

What is the HTI-2 Proposed Rule?

Micky Tripathi, Ph.D., national coordinator for health IT, called the HTI-2 proposed rule “a tour de force” in a recent statement. “We have harnessed all the tools at ONC’s disposal to advance HHS-wide interoperability priorities” said Tripathi. 

The Department of Health and Human Services, through the Office of the National Coordinator for Health Information Technology (ONC), proposed this transformative update in healthcare information technology policy. HTI-2 proposed rule (also known as Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability) provides clear guidelines to enhance interoperability and improve information sharing among patients, providers, payers, and public health authorities. These guidelines complement the HTI-1 final rule released on February 8th, 2024.

Here are 5 key HTI-2 proposals as outlined by HealthIT.gov

1. New certification criteria support health IT certification for public health and payers, focusing on standards-based APIs for better data exchange.
2. Technological updates include the ability for health IT to exchange clinical images and use multi-factor authentication, building on previous regulations.
3. By January 1, 2028, health IT must implement version 4 of the United States Core Data for Interoperability (USCDI).
4. Amendments to the information blocking rules include a new exception for “Protecting Care Access” to mitigate legal risks in certain information-sharing scenarios.
5. Governance rules for the Trusted Exchange Framework and Common Agreement™ (TEFCA™) have been established, meeting the 21st Century Cures Act’s requirements.

Implications for Public Health Professionals

Enhanced interoperability will fundamentally reshape the workflows and processes of public health entities. The HTI-2 rule proposes certification criteria tailored to public health and payer-oriented health IT systems, encouraging deep collaboration between these entities and leading to potential innovations in the patient experience.

For public health professionals, this could enhance the ability to track health trends and measure the effectiveness of interventions. However, the rule also highlights the need to balance data sharing and protecting sensitive health information. Evaluating the security measures to safeguard shared health data is crucial.

Interoperability and the Role of EHR Systems

The HTI-2 proposed rule strongly emphasizes interoperability. It aims to support the exchange of health information across different healthcare systems, which is where Electronic Health Records (EHR) systems come into play.

Fully embracing the new proposed rule may require investment in new technologies or upgrades to existing systems. To achieve full EHR interoperability, your public health department should partner with a trusted EHR vendor that is prepared for the future of public health data. That means they should understand EHR interoperability challenges and have experience promoting interoperability measures.
Whether you are evaluating your current EHR, or shopping for a new one, make sure it is both 21 Century Cures Act Certified and ONC Promoting Interoperability Certified.

APIs and Payer Integration

Interoperability in healthcare is about connecting different organizations, not just integrating within one organization. The government can encourage this connection at a national level. ONC recognizes this and aims to reduce the burden on healthcare providers by strengthening health information exchange (HIE) processes and making payer workflows digital.

This is not entirely new; HIPAA has long required standards related to payer workflows and public health capabilities, which are part of the certification program. However, the ONC is now focusing on certifying the technology used by payers and public health agencies as well as healthcare providers.

HTI-2 aims to enhance interoperability requirements through standards-based APIs, fostering a patient-centered health system with seamless data sharing. The proposed rule aligns with the Center for Medicaid and Medicare’s (CMS) vision to achieve interoperability and sets novel health IT certification needs for payers to reduce administrative burdens and costs.

Data Security Measures

The recent widespread IT outage triggered by the Crowdstrike update has highlighted the importance of strengthening security measures for protected health information (PHI). In an era where digital health information systems are omnipresent, the risks to the privacy and security of this data are more significant than ever.

The HTI-2 proposed rule aims to ensure that healthcare organizations and technology providers implement higher security standards to bolster the protection of individuals’ personal health information. Adding a ‘protecting care access’ information blocking exception reinforces safeguarding reproductive health information.

Choose a HIPPA-compliant, HITRUST-certified EHR. It’s essential to partner with an EHR vendor that prioritizes protecting PHI by providing multi-factor authentication, role-based access control, and secure data sites.

The HTI-2 Proposed Rule represents a significant shift in public health data sharing. It’s a key component of the evolving digital health landscape. As public health professionals adjust to these technological advancements, the goal remains clear: improving the quality of public health through enhanced data sharing and connectivity. Embracing this change requires continuous learning and adaptation. However, with careful planning and execution, and the right public health EHR vendor, healthcare organizations can navigate this transition successfully.