On March 9th, 2020, the Health and Human Services (HHS) released a press bulletin related to the 21st Century Cures Act for interoperability between Electronic Health Record (EHR) systems as well as Application Programming Interfaces (APIs). This work by the ONC is a step forward to further enhance patient ability to have their data sent between entities as well as for more enhanced patient access to their data. The policy is the first step and the implementation for some aspects of the updated legislation could take up to a few years. Either way, organizations should start to understand and plan for relevant changes to their EHR systems and/or other systems that contain patient data. One of the aspects of the change is that Health plans associated with Medicaid, CHIP, and a federal exchange need to be able to share claims data electronically with patients. Below is a link to this reference.
The update in March of 2020 further defines Application Programming Interfaces (APIs) related to the ability of 3rd party applications to connect to Certified EHR systems as well as other components of the electronic data exchanges within the Healthcare community. Interconnections between systems have security and governance rules that are generally more challenging and more costly to manage with a server-based EHR system. These interconnections can be managed more effectively for most Pediatric Offices by leveraging a true cloud-based Pediatric E.H.R. like PediatricXpress. Practices that leverage PediatricXpress have the ability to send patient data via a secure data transfer network to other providers that are on this network. Additionally, the PediatricXpress system maintains connections and data sharing with a number of Clinically integrated Networks for which data is shared to the network. There are more details on the ONC updates that can be found at HealthIT.gov.
This new update from the ONC also provides guidance related to information blocking. Many EHR vendors and/or Health Systems block or limit the data sharing. These entities as well as insurance companies will need to provide a means for patients to access data (not block patients from available information). There are some standards (such as FHIR) and timelines that apply these standards. Most E.H.R. vendors certified to the final standard (2015 ONC Certification) have the ability to send patient files in CCDA format that other entities can use to integrate into their systems. Practices can export these files or use a secure e-mail technology like EMRDirect to send secure emails with a patient’s CCDA record to another provider (assuming the provider maintains a secure email address on the network). Additionally, these CCDA patient files can be sent from one EHR system to a population health management system utilized by most Clinically Integrated Networks. EHR vendors should be leveraging their knowledge and understanding of the CCDA file to plan and align their systems to the future standard of interoperability known as Fast Healthcare Interoperability Resources (FHIR). Additionally, certified products should have APIs that third party developers can develop applications and connect for patients with a security key and approval.
While the new updates in March 2020 provide much information related to the importance of ONC-certified EHR systems enhancing interoperability, data sharing via APIs and open data sharing, there are a number of unanswered details that the EHR and other vendors will need to solve as they start to implement updates to their products and systems.