Bipartisan TRUST IT Act aims to facilitate the exchange of patient information

A new bipartisan bill was introduced into the U.S. Senate that aims to improve the accountability and interoperability of EHRs and other health IT systems. The Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 would expand the government’s ability to investigate cases of “information blocking.”

The TRUST IT Act was introduced in the U.S. Senate on Oct. 6 by Sheldon Whitehouse (D-R.I.) and Bill Cassidy, MD (R-La.) and has earned the support of the ACR.

“Right now, after a health IT product is certified for use, there’s no way to ensure that it continues to deliver as promised for doctors and patients, and no way to easily compare one product to another,” Whitehouse said at the time. “This bill will establish important safeguards to prevent systems from underperforming and will grade them on their performance—changes that will improve market competition and drive innovation.”

If passed, the bill would expand the government’s ability to investigate cases of “information blocking” and penalize those who are found guilty. Information blocking occurs when the overall effectiveness of EHRs are purposefully harmed or interfered with in some way.

Bibb Allen, Jr., MD, chair of the ACR Board of Chancellors, and William T. Thorwarth, Jr., MD, ACR CEO, penned a letter to Whitehouse and Cassidy, praising the bill and detailing the ACR’s history of support for interoperability.

“Radiologists, due to the nature of our specialty, are heavily dependent on health information technology to complete the important task of providing life-saving imaging services to patients, including receiving electronic orders, providing interpretation/reports, and communicating findings back to referring physicians and patients,” Allen and Thorwarth wrote. “ACR believes that the TRUST IT Act provides several improvements to the certification, implementation and oversight of health IT by proliferating interoperability and deterring anticompetitive behavior and other non-technological barriers to information sharing.”

Michael Peters, ACR director of legislative and regulatory affairs, told that information blocking by hospitals and EHR vendors limits choices for patients and can restrict the flow of electronic orders and imaging data between unaffiliated or competitive imaging centers.

“The consequences of e-ordering limitations on patients can include higher costs, decreased competition, lower levels of quality and customer service, patient inconvenience, and so on,” Peters wrote in an email. 

He added that the best part of the TRUST IT is that it would expand the U.S. Department of Health and Human Services Office of Inspector General’s (OIG) authority—beyond the currently covered EHR exception and safe harbor from self-referral and anti-kickback requirements—to investigate and monetarily penalize any act of information blocking related to certified health IT.

“If this expansion of OIG’s authority were to become law, it could drastically reduce anticompetitive behavior overnight,” Peters said.

Another key part of the TRUST IT Act is that it would create a “development council” to rate EHRs, on a scale of one to three stars, in numerous categories. The council would be required to collaborate with various physicians during this process, improving the ratings’ accuracy and transparency.

“Knowing which EHR solutions and other certified health IT products work well with radiology IT and imaging data would inform providers’ acquisition and implementation decisions, vendors’ product development priorities, even marketing strategies, and so on,” Peters suggested. “Everyone knows that interoperability and exchange is critically important from the perspectives of patient care, quality, and safety—the TRUST IT Act would strengthen the business case.”

The full text of ACR’s letter is available on the organization’s website.