Massachusetts recently released a final regulation concerning its health information exchange, which became effective February 10, 2017. Under this regulation, Provider Organizations are required to connect to Massachusetts’ statewide health information exchange known as the Mass HIway. Provider Organizations include Massachusetts acute care hospitals, community health centers, and medical ambulatory practices. These regulations continue the push toward increased interoperability of patient medical records across health care providers, in an effort to improve the ability of a provider to see the full medical picture of a patient.

Provider Organizations must connect to the Mass HIway over the course of a four year phased-in timeline. For acute care hospitals, year one begins on February 10, 2017. For all other Provider Organizations except small community health centers, year one begins on January 1, 2018. Small community health centers’ first year begins January 1, 2019. Provider Organizations must “connect” to the Mass HIway during each applicable year as follows:

• Year 1: send or receive HIway direct messages for at least one use case;
• Year 2: send or receive provider-to-provider HIway direct messages for one use case; and
• Year 3: send and receive provider-to-provider HIway direct messages for one use case.

In Year 4, the Provider Organization is subject to financial penalties if it fails to connect to the Mass HIway as described above. Additionally, acute care hospitals must send to the Mass HIway information related to the patient demographics and health care encounters regarding emergency department visits and hospital admissions, discharges and transfers. Such information must be sent within 12 months after the launch of the HIway-sponsored “Event Notification Service” or “ENS.” The ENS is a service that will provide real-time alerts about certain patient encounters.

For health care systems with multiple Provider Organizations, the requirements set out in the regulation will apply to each individual Provider Organization within the health care system.

Mass HIway participants must provide each patient or the patient’s authorized representative with written notice of how the organization uses the Mass HIway. Among other things, the notice must include a description of how the patient can opt-out of HIway-sponsored activities.

Waivers of the Mass HIway requirements are available to Provider Organizations that meet certain conditions, such as lack of internet or broadband internet access.