EHI Definition. The Academy is a staunch advocate of interoperability and data portability; however, we are concerned about the implications of the definition of EHI used in this draft of TEFCA. The definition of EHI is exceedingly broad. The shear breadth of information contained in the definition of EHI will complicate compliance with and enforcement of the TEFCA. We have already seen the consequences of requiring clinicians to exchange data without establishing minimum necessary standards. Health care organizations will send everything to ensure they comply with the requirement to exchange.1,2,3 This was the case under the Meaningful Use Program. Clinicians may find it easier and feel safer (from an enforcement perspective) to simply disclose everything they have. The receiving physician then has to deal with the information overload – sifting through a mountain of information to find the few components that are relevant and important to patient care. While we appreciate ONC’s recognition of the conflict between the broad EHI definition and HIPAA with language reinforcing that HIPAA preempts TEFCA, it is a solution to a problem that does not need to exist and imposes significant burden on the clinician. Attempting to determine how much information to divulge so as not to violate HIPAA and face OCR enforcement or violate the MRTCs amounts to significant cognitive burden. Those who do make such determinations are required to create new policy and procedures. Both scenarios are a result of increased regulatory complexity that contradicts Congress’ intent to reduce physician burden.
