SDOH and Health Equity: Summarizing the EHRA Congressional Briefing – Part 2

Ambulatory and Health System Perspectives

By EHRA Public Policy Leadership Workgroup

Part one of this two-part blog series summarized insights around SDOH and health equity from the developer and community perspectives, which were shared during the recent virtual Congressional Briefing hosted by EHRA’s Public Policy Leadership Workgroup. Part two shares the ambulatory and health system perspectives. The presentation slides and full briefing (passcode: H@R$UZ02) are available in the “Positions and Statements” section of EHRA’s website. 

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SDOH and Health Equity: Summarizing the EHRA Congressional Briefing – Part 1

Developer and Community Perspectives

By EHRA Public Policy Leadership Workgroup

Health equity and social determinants of health (SDOH) currently play a large role in the national conversation on health care, with the Biden Administration ranking it as one of its highest priorities. Practically, however, these discussions have been underway for years.

SDOH and health equity are a public policy and care coordination challenge, one that health IT can play an important role in resolving. Consider that 80% of health is determined by non-clinical factors. However, there is a wide information gap separating healthcare organizations and the social and community agencies at the forefront of identifying and addressing these socioeconomic needs. Health IT and interoperability standards facilitate the secure, seamless exchange of patient data between these environments to improve population and individual patient health outcomes.

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The USCDI Curation Process: Why Stratify?

By John Travis and members of the EHRA Information Blocking Task Force 

In our last blog on the United States Core Data for Interoperability (USCDI), the focus was on USCDI as the policy ground for advancing federal interests for promoting high impact needs for health data, and USCDI’s import as a certification specification impacting developers of Certified Health Information Technology (CHIT). In this blog, we focus on how the evolution and curation of USCDI impacts the efforts of health IT developers and implementers to “stay current.” 

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The Balance Challenge for Policy in Progressing the U.S. Core Data for Interoperability (USCDI)

By John Travis and members of the EHRA Information Blocking Task Force

 

With publication of the 21st Century Cures Act: Interoperability, Information Blocking , and ONC’s Certified Health IT program final rule (Cures Act Final Rule), the Office of the National Coordinator for Health IT (ONC) worked to implement important provisions of the 21st Century Cures Act (Cures Act) for nationwide interoperability. The initial proposal from ONC addressing the Trusted Exchange Framework and Cooperative Agreement (TEFCA), which was also required by the Cures Act, created a central role for the U.S. Core Data for Interoperability (USCDI) in federal health IT policy, and it is important to consider what that role will be in the national policy framework. Will the USCDI push the industry beyond where it would go on its own by being progressive in its version expansion? Will it affirm and codify an extension of the current state, adhering to a principle of expansion based on supporting pre-requisites of already established interoperability standards? Or something in between?

In recent deliberations of the USCDI Task Force of the Health Information Technology Advisory Committee (HITAC), the Federal Advisory Committee established under the Cures Act, this tension point has come to light. The members of the task force seem to have two perspectives on the matter. 

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Securing API-based Access to Patient Data

By EHRA Standards & Interoperability Workgroup

One of the goals of the 21st Century Cures Act’s health IT provisions was to enable patients to have secure access to their electronic health information using Application Programming Interfaces (APIs). The Office of the National Coordinator for Health IT (ONC) advanced that objective when it published its May 2020 Final Rule, which specifies HL7(R) FHIR(R)-based standards that health IT developers (as well as provider organizations developing their own solutions) will be expected to implement so that patient can access their health data using apps of their choice, connected to APIs. But how can patients be assured that their health information is secure once it leaves the EHR? 

Health data are among an individual’s most sensitive information, obligating all members of the healthcare community to protect patient privacy by ensuring secure data exchange. This blog post will review how the ONC standards for patient access can enable best practices to securely share patient health data.

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Health IT and Public Health: Past, Present, Future

For COVID-19 resources for health IT developers and other stakeholders, click here.

By Kedar Ganta, Co-Chair, EHRA Standards & Interoperability Workgroup

For centuries, public health has been a story of the quest to find effective means of preventing diseases, containing outbreaks and analyzing health trends in the population. 

The “old” public health ecosystem focused on the environment, while the “new” public health focus is on the individual within a given population. Shifting the focus from finding sources of epidemic and endemic infectious diseases in our surroundings to finding them in the individual necessitated an evolution from trial and error to scientific inquiry that revolves around defining diseases, measuring their frequency and seeking effective interventions.

During the 20th century, science and technology reshaped our shared understanding of diseases and helped restructure public health and medicine. This “new” era will be guided by the rapidly growing availability of health data to detect, observe and understand health patterns at a population level using advanced computing and analytics.

Electronic health records (EHRs) continue to play an important role in influencing and improving population health outcomes by efficiently collecting standardized individual data that can be shared among different healthcare organizations and public health agencies.

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