Advancing Health Data Interoperability: Key Highlights of the ONC HTI-2 Proposed Rule

The Office of the National Coordinator for Health Information Technology (ONC) recently proposed the Health Data, Technology, and Interoperability (HTI-2) rule, aimed at enhancing health data exchange and interoperability. This proposal marks a significant step towards achieving seamless data flow across healthcare systems, ultimately improving patient care and operational efficiency. Here are the key highlights from the proposed rule:

Background and Context

The ONC HTI-2 proposed rule builds upon previous regulations, particularly focusing on expanding the capabilities of Health IT Modules. These enhancements are designed to facilitate better exchange of clinical, coverage, and prior authorization information among healthcare providers, payers, and patients.

Key Provisions of the HTI-2 Rule

1. Patient Access to Health Information:

   • Patients (and their authorized representatives) will have the capability to download both diagnostic quality and reduced quality images starting January 1, 2028. This ensures patients can access and share their medical imaging with ease .

2. Enhanced Data Transmission Methods:

   • The rule mandates that patients must be able to transmit ambulatory and inpatient summaries via email and encrypted electronic methods. This includes the ability to select specific dates or date ranges for the data they wish to view, download, or transmit .

3. Activity History Logs:

   • When patients use the capabilities to view, download, or transmit their health information, detailed logs of these activities must be recorded and made accessible to them. This includes recording the actions taken, the date and time, the user who took the action, and the recipient of the transmitted data .

4. Interoperability and Prior Authorization Processes:

   • The proposed rule includes certification criteria to support effective exchange of clinical, coverage, and prior authorization information. This aligns with the requirements established in the Interoperability and Patient Access Final Rule and the CMS Interoperability and Prior Authorization Final Rule .

5. Diagnostic Image Reporting:

   • From January 1, 2028, certified Health IT Modules must support the download of diagnostic quality images and provide imaging links in ambulatory and inpatient summaries. This ensures comprehensive access to diagnostic information for patients and healthcare providers .

Standards and Implementation Guides

The proposed rule incorporates various standards and implementation guides to ensure consistency and reliability in health data exchange. Notable standards include the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®), Logical Observation Identifiers Names and Codes (LOINC®), and RxNorm. These standards provide a framework for representing electronic health information and ensure interoperability across different health IT systems .

Conclusion

The ONC HTI-2 proposed rule represents a pivotal advancement in health data interoperability. By enhancing patient access to health information, streamlining data transmission methods, and incorporating robust standards, the rule aims to create a more connected and efficient healthcare ecosystem. As the healthcare industry moves towards greater interoperability, the proposed rule sets the stage for improved patient outcomes and operational efficiencies.

For more detailed information, you can access the full ONC HTI-2 Proposed Rule document here.