A pair of recent announcements from the U.S. Department of Health and Human Services show agencies working to help providers and payers reduce their data exchange burdens and enable Medicare enrollees to better manage their chronic conditions.
RFI to enhance data exchange
On Tuesday, the Assistant Secretary for Technology Policy/Office of the National Coordinator (ASTP/ONC) for Health Information Technology and Centers for Medicare & Medicaid Services (CMS) announced a joint request for information to help advance a seamless, secure and patient-centered digital infrastructure that ensures health information is not locked away in silos and flows securely to patients and providers.
The RFI from CMS and ASTP/ONC asks the public how technology could be used to help them make better informed health decisions and increase health data interoperability across all stakeholders.
"We are building a future where seniors and families have the digital tools they need at their fingertips – tools that help them make informed choices, manage chronic conditions and stay healthy," said Stephanie Carlton, CMS chief of staff and deputy administrator, in a statement.
"The government must be a catalyst, not a barrier, to unleashing American innovation in healthcare," she added.
Specifically, the agencies request input from patients, caregivers, providers, payers, technology developers and other stakeholders on how they can:
- Drive the development and adoption of digital health management and care navigation applications.
- Strengthen interoperability and secure access to health data through open, standards-based technologies.
- Identify barriers preventing the seamless exchange of health information across systems.
- Reduce administrative burden while accelerating progress toward value-based, patient-centered care.
"CMS and ASTP/ONC would like to continue to build on the existing policy framework to drive large-scale adoption of health management and care navigation applications, reduce barriers to data access and exchange, realize the potential of recent innovations in healthcare that promote better health outcomes and accelerate progress towards a patient-centric learning health system," they said in the RFI.
The public comment period will be open through June 16.
FHIR APIs slashed care approval time
Previously, HHS had notified the public that the International Da Vinci Project Report, published initially on Jan. 17 but part of the Regulatory Freeze that began Jan. 20, has been reissued for publication. The report includes test results from using the Health Level Seven Fast Healthcare Interoperability Resources standards approved for use under HIPAA privacy rule exceptions.
National interconnectivity fueled by FHIR APIs could significantly reduce the burden associated with health data exchange, according to participants of HL7 programs conducting various tests.
Health systems used the Clinical Data Exchange specs developed by HL7's Da Vinci Project to build a FHIR-based data-as-a-service platform, and a CMS-approved exception permitted Da Vinci members to test the alternative.
Instead of the HIPAA-adopted standards for referral certification, they used exchange methods described in the HL7 FHIR Prior Authorization Support Implementation Guide and the HL7 FHIR Coverage Requirements Discovery IG for their prior authorization transactions and to confirm eligibility under a health plan, according to the agency's notice published April 29.
Over the past few years, CMS has sought to modify HIPAA to support claims and prior auth transactions, streamlining administration between payers and providers and thus minimizing delays in patient care.
Da Vinci participants found that the alternative HL7 FHIR standards significantly improved the process compared to the existing standard, HL7 said in a blog post this past November.
Two participants, Regence, a payer, and Washington-based MultiCare Health System, tested data exchange using the FHIR standard for APIs, while dozens of other providers and partners tested it during HL7 connection events, the organization said.
Using the FHIR APIs, Regence and MultiCare achieved at least 140% improvement in the time it took to complete individual point-to-point transactions.
"Our project has proven that the efficiency gains from using this [FHIR] workflow are above anything else available in the marketplace today," said Anna Taylor, associate vice president of population health at MultiCare, in HL7's blog.
Implementing exchange through FHIR APIs took about a week, Taylor noted.
Through Da Vinci’s separate Trebuchet project, Regence and MultiCare and other organizations are testing the use of FHIR APIs to exchange data via Qualified Health Information Networks under the Trusted Exchange Framework and Common Agreement.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
