The Office of the National Coordinator for Health Information Technology is removing a specified web-accessibility requirement from certification for technology that lets patients view, download and transmit their health records. The final rule, published October 28, retains those record-access capabilities and says it does not alter obligations under applicable civil-rights laws.
The check being removed
From December 28, the view, download and transmit certification criterion will no longer require conformance with Web Content Accessibility Guidelines 2.0 Level A, or optional Level AA.
ONC says the baseline has been part of this criterion since the 2014 Edition and is now sufficiently widespread. It expects developers to retain accessibility features and consider other ways to make viewing accessible. That is the agency's expectation, not a finding that every product will keep the same features.
The rule acknowledges that certification serves a distinct purpose: evaluating specified technology functionality. Civil-rights laws instead impose duties on the entities those laws cover.
The disagreement in the record
The rule says the majority of commenters addressing this proposal opposed removing the accessibility requirement. Concerns included reduced accessibility for patients with disabilities and more responsibility for healthcare providers to evaluate the systems they buy and use.
Supporting developers described the requirement as outdated or duplicative and said removal would reduce certification burdens and allow design flexibility.
ONC finalized removal. It says the rule does not change obligations under the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, Section 1557 of the Affordable Care Act or other applicable federal or state laws.
What the criterion retains
The revised regulatory text still requires internet-based viewing, downloading and transmission of specified health information by patients and authorized representatives. It retains date and date-range selection and an activity history available to the patient or representative showing the action, its date and time, the user and, where applicable, the addressee to whom an ambulatory or inpatient summary was transmitted.
The rule also removes the criterion's requirement to conform to a Network Time Protocol standard. It does not remove the requirement to record the date and time of each action.
These are certification changes. The rule does not establish whether a particular patient's portal will change or whether access will become easier or harder in practice.