Build or Buy? HTI-2 Presents Health IT Vendors With a Strategic Fork in the Regulatory Road – Regulatory Talk Series

October 11, 2024 | Article Link

With the public comment period now closed, the newly renamed Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology (ASTP/ONC) has received substantial feedback on its proposed HTI-2 regulation, particularly regarding its efforts to align multiple regulatory agencies.

For health IT developers, HTI-2 marks a critical decision point. Health IT vendors have long grappled with the tradeoffs between building and maintaining capabilities like e-prescribing in-house or outsourcing to platform providers like DrFirst. These concerns often center on whether e-prescribing is considered critical intellectual property, whether platform providers can deliver adequate service and innovation, and whether the economics justify outsourcing.

With HTI-2 introducing more stringent certification requirements and enormous demands, the discussion reaches a tipping point. Developers must now choose between investing in additional in-house functionality, managing multiple third-party integrations, or adopting next-generation platforms that promise streamlined, one-time integration. These platforms could eliminate the need for ongoing updates, reducing compliance burdens while enhancing workflows and data-driven insights—an attractive option in an increasingly complex regulatory landscape.

Adapting to HTI-2’s E-Prescribing and Workflow Enhancements

HTI-2 introduces significant updates to the e-prescribing landscape, most notably the required upgrade to NCPDP SCRIPT version 2023011 by January 1, 2028. In addition, prescribers will need to adopt structured and codified prescribing instructions (sig), replacing free-text entries with standardized codes to help reduce errors. Another key change under HTI-2 is the integration of electronic prior authorization (ePA) capabilities, which will streamline approval processes and improve patient access to medications.

Key Takeaway: Health IT developers must prioritize the upgrade to NCPDP SCRIPT version 2023011, incorporate structured sig support, and integrate ePA functionality. Early planning will help developers align with these requirements, avoid compliance disruptions, and streamline workflows, improving care delivery.

Unifying E-Prescribing with Price Transparency

HTI-2 also emphasizes combining e-prescribing systems with real-time prescription benefit (RTPB) functionality. Now a certification requirement, price transparency tools provide real-time insights into prescription costs, coverage, and alternatives, enabling providers and patients to make more informed, cost-conscious decisions. Integrating RTPB with e-prescribing enhances medication management and ensures compliance with federal standards for price transparency.

Key Takeaway: Meeting HTI-2 requirements goes beyond merely supporting price transparency transactions. Vendors must fully and seamlessly integrate e-prescribing with RTPB features into clinical workflows, empowering clinicians with the real-time insights necessary to make informed, decisive choices about medication options, pricing, and coverage. This not only ensures compliance with dual certification standards but also significantly streamlines the process, making it more efficient and impactful for healthcare providers.

Beyond HTI-2: Orchestrating Smarter Compliance Pathways

To meet the base EHR requirements under HTI-2, health IT vendors must certify their systems for both e-prescribing and real-time price benefit functionalities. This is particularly critical for vendors working with Medicare-eligible hospitals and clinicians, as it directly affects their eligibility for CMS incentive programs. Securing these certifications is essential not only for compliance but also for staying competitive and retaining customers in a rapidly evolving market.

HTI-2 brings substantial changes, making compliance both a necessity and an opportunity for vendors that move quickly. For those concerned about the complexity of frequent platform updates to meet new regulations, next-generation medication management platforms provide a compelling solution.

As a leader in this space, DrFirst introduced the first prescription orchestration platform in July 2024. Now is an opportune time to explore the benefits of this new framework, which streamlines medication management and gives vendors greater control over how new connections and capabilities are integrated—before future regulations dictate specific requirements.

The compliance demands of HTI-2 are significant and add to the burden of other core EHR mandates. This highlights the value of partnering with a trusted platform vendor that can handle ongoing e-prescribing regulatory changes, freeing EHR technical teams to focus on compliance and the enhancement of other key functionalities.

Unsure how to reconstruct your roadmap to meet the new e-prescribing standards while trying to juggle multiple compliance deadlines? Register to attend Nick’s HTI-2 webinar on Oct. 24, 2024.

About Nick Barger, PharmD 

Nick is Vice President of Product at DrFirst, where he leads design and development of intelligent medication management solutions for the e-prescribing pioneer and the 300 EHRs and health information systems they partner with, providing clinical, regulatory, and digital workflow solutions that make healthcare more efficient and effective. Check out all the articles in the Healthcare Regulatory Talk series.