60-day FRN Comment Received OS-0955-0019 HIO

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Barker, Wesley (OS/ONC)
Barker, Wesley (OS/ONC)
RE: Comments on OS-0955-0019, National Survey of Health Information Exchange Organizations (HIO)
Tuesday, August 4, 2026 9:19:36 AM

From: Brendan Keeler <[email protected]>
Sent: Monday, April 20, 2026 2:34 PM
To: Chang, Wei (OS/ONC) <[email protected]>
Subject: Comments on OS-0955-0019, National Survey of Health Information Exchange Organizations (HIO)

Dear Ms. Chang,
I appreciate the opportunity to comment on the proposed revision of the National Survey of Health
Information Exchange Organizations. My comments focus on structural gaps in the prior instrument that the
revision should address.
1. HIN self-identification under the information blocking rule.
The survey asks HIOs extensively about information blocking by others but never establishes whether the
respondent considers itself a Health Information Network as defined in 45 CFR 171.102. This is the single
most important regulatory self-classification for an HIO, and the definition is functional rather than
structural, meaning the population of self-identified HINs is not otherwise known to ONC. I recommend
adding a question asking whether the HIO considers itself a HIN, with follow-ups on the basis for that
determination, whether legal counsel was involved, and whether the organization has implemented
information blocking compliance policies and exception documentation.
2. Individual right of access capabilities.
The current instrument has no questions on whether or how HIOs fulfill individual requests for access to
records they hold. HIOs sit on some of the richest longitudinal patient records in the country, and their
practices around individual access are directly relevant to information blocking enforcement. I recommend
a section capturing whether the HIO accepts individual requests, annual volume, fulfillment timeframes,
supported modalities (portal, API aking to (g)(10), TEFCA IAS, manual ROI process), fee practices, denial
rates and reasons, and the HIO's self-determination of HIPAA status (covered entity, business associate, or
neither) for individual right of access purposes. Given the importance of patient access to this
administration, it feels appropriate to understand how HIEs support this today.
Thank you for considering these comments.
htdhealth
Brendan
Keeler
Interoperability Practice Lead
HTD

htdhealth