Kyle Meadors

Reader of regulations and surveyor of standards in all things health IT. I'll still be your friend if you don't like soccer. Chart Lux Consulting.

[Belmont Women’s Soccer @BelmontWSoccer]

Welcome to Nashville, Ava👏🔥

#ItsBruinTime

[Office of the National Coordinator for Health IT @ONC_HealthIT]

New final rule from ASTP:
✅ Streamlined prior authorization via FHIR
✅ Real-time drug costs at the point of care
✅ Updated eRx standards

Less red tape. Faster access. Better outcomes.
#HealthIT #FHIR

https://t.co/DWvLao6enm

[Kyle Meadors @kylemeadors]

@Karl_Townes Erik Daniels
Gerald Fitch
DeAaron Fox
Ed Davender
Derek Anderson

[Kyle Meadors @kylemeadors]

So we have the #ASTP #ONC HTI-2 FR out! BUT, it is really just part of the proposed rule. HTI-2 FR deals with the TEFCA proposals and a few other administrative changes. The rest (USCDI v3, expanded API, public health, etc.) will come in later HTI-? rule. https://t.co/uC4B6TqQuA

[Kyle Meadors @kylemeadors]

@healthapiguy I'm still chewing through it but yea, this seems like this should have been separated into separate HTI-2 and HTI-3 NRPMs and maybe even an HTI-4 instead of all packaged together. There is a lot here.

[Kyle Meadors @kylemeadors]

I’ve obviously just quickly perused this and need more time, but proposed HTI-2 is far more complex than HTI-1. HTI-1 was mostly extending functionality from previous #ONC Cures and Edtions rules. HTI-2 is branching out in new areas and in new ways.

[Office of the National Coordinator for Health IT @ONC_HealthIT]

NEW PROPOSED RULE: Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2). Read the proposed rule: https://t.co/y27y8hEDdT #ONCHTI2

[Kyle Meadors @kylemeadors]

And of course today CMS also released their NPRM on PFS which has updates on MIPS 2025 proposals among other things. I guess I'm just happy they dropped these both today instead of last week before the 4th.

[Kyle Meadors @kylemeadors]

The proposed regulation text section itself is 200 pages long. That is basically the same size as the original 2011 Edition Final Rule, including comments/responses all put together. This is a big document.

[Kyle Meadors @kylemeadors]

Another comment on HTI-2's complexity. NPRM is over 1000 pages of PDF double space format ONC uses. That is basically the same size as a FR which typically double from their NPRM size because of all comments/responses in the preamble. HTI-2 FR will likely be close to 2000 pages.

[Kyle Meadors @kylemeadors]

@healthapiguy @HealthIT_Policy @mickytripathi1 I look forward to you taking the mike at HIMSS25 at ONC panel to propose changes and Steve responding...

[Kyle Meadors @kylemeadors]

@ONC_HealthIT It works! Looks good. Can't wait to start using it.

[Kyle Meadors @kylemeadors]

@healthapiguy Finally, I'm sure ONC would quibble with the "inactive" phrase since they are active criteria but just not applicable to any CMS program at the moment to my knowledge.

[Kyle Meadors @kylemeadors]

@healthapiguy If you really want to be pedantic, you could put c.2-c.3 in their own subcategory of CEHRT because they are only needed in CEHRT IF you submit eCQM. If you use a qualified MIPS registry, you don't have to have c.2-c.3 for your CEHRT definition but that may be too complicated.

[Kyle Meadors @kylemeadors]

@ONC_HealthIT I'm getting a 404 error at https://t.co/RXHXSibmU5.

[Kyle Meadors @kylemeadors]

@healthapiguy I agree. It goes back to 2014 Edition when ONC introduced Cancer Case criteria but made it ambulatory only. Then antimicrobial was later added but only picked up in the inpatient PI program.

[Kyle Meadors @kylemeadors]

@healthapiguy For a.4, it use to be in old MU measure with CDS (a.9) but that is gone. Still, I think they keep primary because it is a rather obvious need for any modern eRx implementation.

[Kyle Meadors @kylemeadors]

@healthapiguy In HTI-1 NPRM, ONC mentioned possibly using b.7/b.8 to enforce the patient-requested restrictions. They dropped the requirement in FR, but I think they are keeping them active in case they use in future, but I don't know any program "requiring" it at the moment.