The COVID-19 pandemic is still at large, operating in waves and through transmutation. It appears that its effects are destined to linger for many years to come. While most of these effects have been devastating, the pandemic has had one profound positive effect on the healthcare industry. Federal agencies such as the ONC, FDA and CDC had adopted a roadmap designed to address the needs of individual patients. This subtle change in the strategy makes seamless health IT interoperability a crucial requirement to master public health reporting, patient matching and reducing provider burden.
In 2015, the ONC had released the Nationwide Interoperability Roadmap to elucidate steps required to implement an evolving health system that was well connected. With this blueprint, the HHS sought to address health disparities, advance precision medicine, facilitate the seamless exchange of Electronic Patient Health Information (ePHI) and vitalize reimbursements for a Value-Based Care Setting.
Half a decade later, the headway has been impressive, but the show has only begun. On the technical front, the twin regulations from the ONC and CMS (The Information Blocking Final Rule and The Interoperability and Patient Access Final rules) have prepped the stage around FHIR and ePHI exchange through APIs. The regulations have also established the need for the USCDI standard to establish the granular unification of ePHI into an entity that can easily traverse the length and breadth of the HIT landscape.
“Together, these technical standards will unify data formats on EHR systems, the mission control center of the healthcare ecosystem, to overcome interoperability challenges.”
Getting Ahead of the Game
Remarkably, the HHS’s efforts to drive this vision with the 2020’s Cures Act Final Rule has catalyzed significant progress. The reliable and meaningful use of ePHI and its availability for the right people at the right time is on the horizon; however, the strict deadlines accompany the technical requirements of the Cures Act Final rule.
A well-planned interoperability roadmap can be vital for HIT vendors to ensure steadfast growth and regulatory compliance. Here’s are the milestones HIT developers must pursue in the months to come:
Consent Management: The technical requirements of the regulations demand payer and provider organizations share patient information. HIT vendors must now factor patient privacy into this equation. Providers and payers must ensure that the patient health information they share was authorized by the patient. Patient and member portals might be among the easy ways to capture consent right at the ‘field’ or ‘record instance’ level. However, getting the system to work in harmony requires immense cerebral effort from HIT developers, making consent management an important milestone in the roadmap.
Authentication: User seeking access to patient health information range from patients and members to case managers, clinicians and health insurance management staff. All of them currently use multiple portals to access specific data across disparate HIT systems. To expect them to remember their credentials for every instance of use on a portal is impractical. Therefore, it would be prudent to tie the authentication mechanism with something they use. Furthermore, enabling the users to access data through the API using the same credentials to access current portals would simplify the user experience. Hence, the API must ascertain user identity to avoid the re-entry of credentials with every user request to access the ePHI repository.
Exception Management: The information blocking mandate establishes eight exceptions that organizations can utilize to disallow ePHI access. HIT developers must now conceptualize solutions to ensure that these exceptions are infused into the API access portals. They must also ensure that every instance of information blocking accompanies evidence-based reasoning to justify it.
Complete Patient/Member Profile: The information that patients and members seek is dispersed across multiple HIT systems. All of these HIT systems operate off different databases. HIT vendors must now scramble to standardize these varying data formats into a single FHIR based infrastructure that can be transmitted across these ‘boundaries’, limiting the seamless exchange of healthcare data. Enterprise Data Warehouses (EDW) could be a compelling solution to distill data from scattered data sources to host and exchange the ‘complete’ patient profile.
Testing and Certification: Product testing and certification enhances the confidence of the target market. Robust testing protocols would ensure consistent performance. Since providers and payer organizations will eventually hold technology developers accountable for performance, product testing marks the thin line between market excellence and dwindling sales numbers, especially for EHR developers.
In Conclusion
Many technological choices await HIT developers, some of which may appear insignificant in the initial stages. However, they can send shock waves down the revenue cycle of these HIT development firms should they become infeasible for practical deployment to production. From cost escalations to legal complications, the ramifications of misjudging the technical requirements of healthcare interoperability are many.
Drop us a line at info@nalashaa.com to learn how our team of healthcare IT experts can add value to your healthcare interoperability journey!
Puneeth Salian
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