December 9, 2020
If the last decade was about electronic health record (EHR) adoption and improving the use of these tools, then the next decade will be driven by “information blocking” policies stemming from the 21st Century Cures Act signed into law in 2016. The rules implementing these policies are aimed at information sharing and putting the consumer truly at the center of their care by ensuring they have easy access to their health records and information – including through sharing policies enabled by application programming interfaces (APIs) and third-party apps.
The COVID-19 pandemic hit just as our sector was preparing to absorb the rules around these new interoperability policies. Providers’ attention was quickly diverted to fighting the rapidly evolving public health crisis, including standing up telehealth and connected care technologies en masse nearly overnight, converting a significant percentage of their workforce to remote work, and combatting supply chain challenges around personal protective equipment (PPE).
Recently, Infor’s Jerry Rankin and I discussed the current state of healthcare interoperability and several of the above mentioned challenges our industry has faced throughout the pandemic during a roundtable discussion. During our talk, we identified some of the concerns highlighted by the pandemic including:
- Lack of regulatory protection of patient data outside of providers and payors.
- Disproportionate hardship placed on minority populations, people of color, and other at risk patient groups.
- Manual – spreadsheet-based – reporting, a reliance on the fax machine, and the associated burdens that go along with these reporting structures.
- The inability of emergency providers to access comprehensive patient histories.
- Limited visibility into clinical data for predictive supply chain practices.
- Deficiencies in the identification and tracking of beds, equipment, and staff.
The good news is that thanks to efforts stemming from policies put into place more than a decade ago under the Health Information Technology for Economic and Clinical Health (HITECH) Act – included in the American Recovery and Reinvestment Act of 2009 – there is near-ubiquitous electronic health record (EHR) adoption among acute and ambulatory providers. The EHR technology in place today played a crucial role in supporting data collection and clinical decision support activities during COVID-19. Without these tools in place, our healthcare system would have been severely disadvantaged in fighting outbreaks in hot spots across the nation.
Interoperability today has led to numerous successes related to collecting and sharing some patient and operational data, even leading to efficiencies across facilities. Like many industries across the world, however, the pandemic has laid bare many of healthcare and interoperability’s shortcomings. For years many, including CHIME, have been saber-rattling on the need for more data standardization. One example of the areas of shortfall spotlighted by COVID-19 is how current standards and existing interfaces across the industry are insufficient and that much more investment is needed to obtain the goal of achieving a sophisticated digital infrastructure.
Of course, in addition to juggling the fight against COVID-19, providers also need to begin preparing for compliance with the information blocking mandates and their companion requirements issued by CMS. These are the same requirements I previously mentioned which will shape the next 10 years of healthcare. The requirements center on the interoperability of patient data through APIs, the movement of payer data, and policies requiring providers to send an alert upon a patient’s admission, discharge, or transfer (ADT). Tomorrow’s new information blocking era must use these requirements as a foundation and continue to focus on modernizing data reporting requirements and methodologies to support public health and work to ensure patient data is available across the whole care continuum. Fast Healthcare Interoperability Resource (FHIR) enabled tools embedded in these requirements are the key to supporting the connected care continuum goal governed by the patient and will even “future proof” the health system as it works to capture encounter data through telehealth and remote patient monitoring.
For all the hope we are pinning on APIs and FHIR, we are still challenged with overcoming the ability to accurately identify patients and correctly match them to their records. This not only serves as a threat to patient safety but also to interoperability, which is the ability of the healthcare system to accurately identify patients at the point of care and correctly match them to their medical records. Until Congress removes the two-decades-old ban that prohibits HHS from developing a patient identification standard, unacceptably high mismatch rates will persist.
CHIME has been at the forefront of advocating for the removal of this ban and is a founding member of Patient ID Now, a coalition of over 30 healthcare organizations representing a wide range of healthcare stakeholders committed to removing this ban and advancing a nationwide strategy to advance patient identification. The coalition welcomes all groups, at no cost, with the desire to work together to repeal this harmful ban and pave the way for a robust patient identification system in the U.S.
If you have an interest in joining us in our fight to accurately match patients to their medical records, or want to join me in continuing to push the innovations sparked by the pandemic, please contact me at email@example.com. After all, it is together that we can continue to improve our healthcare system, keeping the patient at the center, and ensuring the nation’s healthcare system can deliver the promise of 21st Century Care. COVID-19 has highlighted our shortcomings, but it can pave the way for us to do great things with new technology.
Mari Savickis, Vice President, Public Policy, CHIME
To learn more, watch this video round-table discussion with Infor and CHIME, Connected healthcare: The state of interoperability in 2020 and into the future.