ASTP/ONC Finalize Select Policies to Promote Interoperability

December 19, 2024 – The Assistant Secretary for Technology Policy/Office of the National Coordinator for Heath Information Technology (ASTP/ONC) recently finalized a pared down version of its Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule, originally published in July.

Select finalized policies were released through two separate final rules:

1. Health Data, Technology, and Interoperability: Trusted Exchange Framework and Common Agreement (TEFCA) (HTI-2) Final Rule; and
2. Health Data, Technology, and Interoperability: Protecting Care Access (HTI-3) Final Rule

Both rules aim to advance interoperability and support the access, exchange, and use of electronic health information, and build upon the HTI-1 rule finalized in December 2023.

The HTI-2 final rule focuses on TEFCA, a federal effort to develop a trusted framework to support improved exchange of health data between health information networks across the nation. The rule identifies reasonable and necessary activities related to limiting data exchange to only TEFCA that do not constitute information blocking. It also sets governance rules and procedures for the onboarding and designation of Qualified Health Information Networks (QHIN).

The HTI-3 final rule addresses additional information blocking exceptions that apply more broadly to providers, health information technology (HIT) developers, and others (i.e., not limited to TEFCA participants). For example, ASTP/ONC finalized a new “Protecting Care Access Exception,” which protects providers from information blocking penalties if they withhold electronic health information to protect patients from legal action for seeking reproductive care. However, there is speculation this provision could be overturned by the new Administration. The rule also updates other existing exceptions to information blocking.

Neither rule addresses numerous proposals that would have set federal health information technology certification criteria to promote end-to-end interoperability between providers and public health agencies, as well as payers. These standards would have supported improvements in electronic prior authorization processes, patient access to information, and care coordination. Also missing from the final rules were standards meant to promote better access and exchange of imaging data. However, ASTP/ONC left open the possibility that these provisions could be addressed through future rulemaking.

Learn more about ASTP/ONC’s recent regulations