Health IT to track cancer screenings

Summary#

The SCREENS Act would amend the Public Health Service Act and the Social Security Act. Its stated goal is to make cancer-screening recommendations more accessible and consumer-focused through health technology.

  • The National Coordinator for Health Information Technology must create a national, machine-readable framework for cancer-screening recommendations within one year of enactment, consult named federal health agencies and key oncology stakeholders, and update the framework annually.
  • The framework must be public and work with either the mCODE dataset or the United States Core Data for Interoperability (USCDI).
  • Within five years, the HHS Secretary must use rulemaking to make screening-status functionality a condition of certification and continued certification for covered health information technology. The functionality must use only the minimum necessary patient data and support patients’ access to and correction requests for their information.
  • Within two years, the HHS Secretary must issue guidance encouraging specified health plans to integrate the technology and let consumers opt into certified electronic health record (EHR) technology with the functionality.
  • The Patient-Centered Outcomes Research Institute may support research, pilot projects, implementation, and information-sharing related to interoperable technology and preventive care.

The bill is not law. Its timelines would start only if it is enacted. The supplied materials do not include the amended Acts, so I could not verify what these laws already require.

What it means for you#

  • Patients: The bill would not require you to get screened or change screening eligibility. It would require covered certified health technology to be able to determine whether a patient has completed recommended screenings. The technology must explain how it uses patient data and support access, review, and requests to change that information.
  • Health plans: The bill does not directly require plans to integrate the technology or offer opt-in access. It requires HHS to issue guidance encouraging those steps for Medicaid managed care organizations, Medicare Advantage plans, and qualified health plans offered through ACA exchanges.
  • Health technology developers and certification programs: The bill would make the screening-status functionality a certification condition, with details to be set through notice-and-comment rulemaking.
  • Researchers and the public: The Institute may support related research and pilot projects; the bill does not require it to do so.

Money#

No cost estimate or appropriation is provided in the supplied bill text.

  • The National Coordinator must establish and update the framework, and HHS must issue guidance and conduct rulemaking. The bill gives no staffing or cost estimates.
  • The certification requirement may involve costs for health technology developers and certification programs, but the bill provides no estimate.
  • The Institute may support research and pilots, but the bill does not require funding or specify an amount.

What is unclear#

  • The bill does not define “high-risk factors” or explain exactly which screening recommendations and patient data the framework will cover.
  • Rulemaking will determine the details of the certification requirement; the bill does not set a process for handling missing or disputed patient information.
  • The bill does not specify how HHS guidance should help consumers opt in, or how plans should carry that out.
  • It does not explain how “key oncology stakeholders” will be chosen or consulted.
  • The supplied materials do not show how these provisions would interact with current certification requirements or existing programs.

Case for#

  • A shared, machine-readable framework could make screening recommendations easier for different health technologies to use consistently.
  • Annual updates and a basis in USPSTF and National Cancer Institute recommendations could help keep the framework aligned with those recommendations.
  • Patient information and access protections are written into the certification requirement, while privacy laws continue to apply.
  • The Institute could test and evaluate tools before or during wider implementation.

Case against#

  • The bill does not define important inputs such as “high-risk factors,” leaving key details to later work.
  • A certification condition could require changes to health technology, but the bill gives no cost estimate or funding plan.
  • The framework may identify screening status, but the bill does not set out how errors, missing data, or patient disagreements should be handled.
  • Health plans are only encouraged through guidance, so the bill does not ensure that consumers will have plan-based access to the technology.