Today's Law As Amended

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SB-441 Electronic health records: vendors.(2019-2020)

As Amends the Law Today


 Division 109.7 (commencing with Section 130290) is added to the Health and Safety Code, to read:

DIVISION 109.7. California Interoperability Enforcement Act

 This act shall be known, and may be cited, as the California Interoperability Enforcement Act of 2020.
 For purposes of this division, “office” means the Office of Health Information Integrity within the California Health and Human Services Agency.
 The Legislature finds and declares all of the following:
(a) Lack of health care interoperability enforcement at the federal level has resulted in exploitive business practices by electronic health record (EHR) vendors that limit a health care provider’s ability to appropriately and efficiently exchange, access, and interpret health data across different health care settings.
(b) Lack of health care interoperability hampers industry-wide efforts related to quality improvement, care coordination, patient access to personal health information, and reduction of health care costs.
(c) The West Health Institute estimates that widespread medical device interoperability could eliminate at least $36 billion of waste in inpatient settings across the United States alone. It found that functional interoperability leads to increased efficiency, lower costs, and better quality by reducing redundant testing and clinician time spent manually entering information, in addition to shortening length of stay through more timely transmission of critical information such as lab results.
(d) Although technology to enable interoperability exists, vendors still view the adoption of open interfaces as detrimental to their competitive advantage, and vendors sell bundled solutions or a system of devices with closed, proprietary interfaces.
(e) EHR vendors charge costs above and beyond the initial expense of implementing EHR systems and participate in information blocking and opportunistic pricing, taking advantage of the high cost of switching technologies, the lack of clarity on necessary future upgrades, and the costs to maintain the systems.
(f) Almost half of California’s hospitals are still unable to electronically share patient information with other health care providers in the community.
(g) While federal law establishes a framework for the certification of EHR technology (CEHRT) that includes compliance with certain interoperability standards, there is not adequate enforcement or penalties under federal law to ensure that EHR systems are meeting these standards.
(h) When CEHRT vendors do not meet standards, the providers are left facing disruptions in service and payment penalties.
(i) It is important that existing and ongoing efforts to increase CEHRT standardization be properly enforced to enable the secure transfer of health data and achieve meaningful interoperability between disparate systems.
(j) The State of California should become a national leader and model for proper interoperability enforcement, and be recognized for its ability to improve access and affordability of quality health care.
 (a) The office shall regulate, to the extent authorized under federal law, electronic health record vendors operating in California.
(b) (1) The office shall review federal law and policy, including, but not limited to, Part 170 of Title 45 of the Code of Federal Regulations, to identify opportunities to regulate electronic health record vendors and to establish an interoperability enforcement structure.
(2) Following the review, the office shall promulgate regulations, pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, concerning an interoperability enforcement structure.
 The Complaint and Technical Assistance Division shall be established within the office, and shall serve as the point of contact for health care providers who report dealings with electronic health vendors.
 The Interoperability Enforcement Fund is hereby established in the State Treasury. Moneys in the fund shall be expended, upon appropriation by the Legislature, to the office for administration of this division.