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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The Fight to Control COVID-19 Demands Data

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

COVID-19 arrived unexpectedly as a highly contagious disease that surprised everyone, requiring healthcare providers and public health officials to take quick action and make decisions on how to care for those infected, how to slow down (if not prevent) the spread, how to improve treatment options, and how to identify a vaccine. Yet this pandemic continues to take too many lives and affect too many more.  

To understand how to treat the patients, which risk factors make some people more vulnerable, and why it spread so fast, access to data has been proven essential. A patient’s clinical record to facilitate treating those who are ill, combined with further socio-demographic data to research and identify those at highest risk and new data to support clinical trials – all are essential to flatten and ultimately bend the curve as far down as possible. 

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Enabling Improved Price Transparency In Healthcare

price transparEncyOn June 3, the public comment period on ONC’s NPRM implementing health IT provisions of the 21st Century Cures Act closed. These comment windows offer a unique opportunity to gain a broader perspective on the state of the health IT industry. 

Upon our review of the feedback submitted to ONC, an overwhelming trend emerged—nearly 55% of the 2,013 comments were from individual patients commenting in favor of increased price transparency in the healthcare industry. Patients shared stories of the challenges they faced in determining the cost of treatment before receiving care, and dozens expressed the shock and financial hardship they experienced when they received a bill for their care. 

In the months since the public comment window closed, we’ve seen this demand for healthcare price transparency gain attention across the industry. President Trump issued an executive order, and the Senate is considering the “Lower Health Care Costs Act,” legislation that aims to improve patient access to price information in the healthcare industry.

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Interoperability: Promise and Progress 

Interoperability(1)For healthcare providers and their patients, interoperability holds the promise to substantially improve quality and reduce costs, while enabling coordination of care and engagement of patients with their caregivers. As ONC’s annual Interoperability Forum gets underway, it’s important to focus not just on where we want to be, but on how far we’ve come. 

EHRA members are strong proponents of health information exchange; our members have supported hundreds of thousands of providers in their effort to exchange electronic health information through the development of interoperability modules in their solutions, and participation in industry frameworks such as the eHealth Exchange, CommonWell Health Alliance, and Carequality.  (more…)

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