The American Hospital Association is urging federal health IT officials to scale back and slow portions of a proposed interoperability overhaul, warning that eliminating key certification requirements could threaten patient safety and strain hospitals, particularly rural facilities.
In a Feb. 27 letter to Thomas Keane, MD, assistant secretary for technology policy and national coordinator for health information technology at HHS, the AHA responded to the proposed “Health Data, Technology and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity” rule, known as HTI-5.
The proposal would transition the federal health IT certification program toward Fast Healthcare Interoperability Resources, or FHIR, standards and remove or revise 41 certification criteria, including 34 eliminations and seven modifications, effective upon publication of a final rule or Jan. 1, 2027.
The AHA said it supports expanded use of FHIR but called the timeline unrealistic. The association urged the Office of the National Coordinator for Health Information Technology to provide at least 24 months to transition certification criteria after final rules are issued and to align changes with CMS’ Promoting Interoperability Program.
The association also opposed removing Consolidated Clinical Data Architecture, or C-CDA, criteria, saying many providers, especially rural and underserved hospitals, still rely on that framework. Eliminating it could degrade baseline exchange capabilities or prompt vendors to charge additional fees to maintain the functionality, the letter said.
Beyond interoperability standards, the AHA criticized the proposal to eliminate all 13 privacy and security certification criteria and the associated certification framework. While the agency said the move would reduce burden and free resources for innovation, the AHA argued cybersecurity threats remain elevated and removing baseline requirements would shift risk and potential costs to providers.
The letter also urged ONC to retain current certification criteria for decision support interventions, including transparency requirements for predictive and AI-enabled tools. Hospitals rely on those standards to understand how algorithms are developed, tested and evaluated, the association said.
Similarly, the AHA recommended preserving existing “transitions of care” requirements, including patient-matching elements within continuity of care documents. Removing those “create” requirements could increase the risk of patient misidentification, medical errors and privacy breaches, the group wrote.
The association further opposed scaling back real-world testing requirements for certified health IT, arguing providers depend on testing in live care settings, not just lab environments, to ensure products function as intended.
On information blocking, the proposed rule would formally incorporate artificial intelligence into definitions of “access” and “use.” The AHA asked the agency to issue additional guidance before finalizing those changes, citing potential intersections with HIPAA and state privacy laws.
The group also urged ONC to retain the “third-party seeking modification” exception within the information blocking infeasibility exception, saying its removal could expose providers to liability if outside entities alter medical records without their knowledge.
Finally, the AHA renewed its call to repeal 2024 information blocking disincentives that can reduce Medicare payments and affect participation in federal programs for providers found to have engaged in information blocking. The letter described the penalties as excessive and potentially destabilizing for small and rural hospitals.
Overall, the AHA said it supports reducing unnecessary regulatory burden but asked ONC to maintain core privacy, security and patient safety protections as it modernizes the certification program.
The post AHA urges ONC to slow health IT certification overhaul appeared first on Becker's Hospital Review | Healthcare News & Analysis.
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