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…)

EHR Developers are Aligned with Goals of Cures NPRM, Hope ONC will Remove Ambiguity and Reassess Timeline

Screen Shot 2019-05-26 at 9.15.33 PMWe had been waiting for the Office of the National Coordinator for Health IT to release the proposed rule fulfilling its Cures Act obligation for quite a while. Encompassing important issues like expanded interoperability, defining what is and isn’t information blocking, as well as proposing updated certification requirements, this is an important rule to get right.

Since the release, there have been lots of discussions—public and private, online and off—about intended and potentially unintended impacts of the language in the proposal. With so much to consider and analyze, we appreciate that the request from EHRA and other groups to give us a full three months to draft our comments on the rule was approved.

The tremendously broad reach of the proposed rule goes far beyond Congressional intent.

The EHR Association’s comments are now going through final rounds of review by our executive committee (and the seven workgroups and task forces that contributed their expertise). We worked throughout the drafting of the 21st Century Cures Act with Congress and are supportive of its goal to remove obstacles to information exchange, but we have found that the tremendously broad reach of the proposed rule goes far beyond Congressional intent. In particular, we have significant concerns regarding timelines, ambiguous language, disincentives for innovation, and definitions related to information blocking.

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An EHR Perspective on the Consumer-Focused API/App Landscape

By Hans Buitendijk
EHRA Executive Committee member
Chair, Interoperability & Standards Workgroup

kevin-grieve-712217-unsplashONC’s 2015 Certification Edition for EHRs began supporting consumer access to their health data beyond patient portals. Open APIs were required to enable consumer Apps to access data from the Common Clinical Data Set. Because at the time there were no standards sufficiently mature to establish as a base, the requirement allowed for access by any means as long as the technical specifications, including terms and conditions, were made publicly available to enable App developers to write their Apps on top of these APIs.

A lot has happened since then.
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