Public policies drove the adoption of electronic health records across the United States, but they did not include some types of providers, hampering healthcare’s ability to achieve complete interoperability.
Vice President, Public Policy, College of Healthcare Information Management Executives (CHIME)
Consumers today expect instant access to all types of information at their fingertips, whether it be banking transactions, map data, or any number of other pieces of data available on personal electronics. Accessing healthcare information, on the other hand, is anything but instant, but that may be changing as the U.S. government has gotten serious about data exchange.
Thanks to landmark legislation known as the Health Information Technology for Economic and Clinical Health (HITECH) Act contained in the American Recovery and Reinvestment Act, a big investment in healthcare technology was made beginning in 2009. Importantly, HITECH gave much-needed funding to hospitals and clinicians to invest in electronic health records (EHRs) and, as a result, most of these healthcare providers have EHRs today.
These investments were an important down payment focused on fostering greater digitization of patient data, although it fell short of enabling providers to exchange information seamlessly with one another. One reason for this shortfall is that not all types of healthcare providers were eligible for the above-mentioned programs and, consequently, interoperability across the healthcare sector has not been uniform or without challenges.
A seamless experience
Then in 2016, the 21st Century Cures Act pushed healthcare providers, EHR vendors, and other stakeholders to ensure patient data is appropriately shared with other providers and accessible to patients themselves.
Congress specifically called for — and federal agencies have subsequently mandated — the use of application programming interfaces (APIs); the technology in widespread use today across other industries to facilitate rapid and seamless access to information via third-party apps on smartphones. These APIs should, one day, bring healthcare to the level of seamless data access enjoyed by banking and other consumer-facing industries.
For healthcare, the hope is that APIs will make it easier for patients and clinicians to download, exchange, and manage healthcare information through both EHRs and third-party applications like smartphone apps. The U.S. Department of Health & Human Services’ Office of the National Coordinator for Health Information Technology (ONC) and U.S. Centers for Medicare & Medicaid Services are overseeing the implementation of the 21st Century Cures Act and the ensuing provisions by working to unlock this data long trapped in inaccessible siloed systems.
Also included in the 21st Century Cures Act is a set of terms and conditions for how this data exchange will operate, known as the Trusted Exchange Framework and Common Agreement (TEFCA). Currently planned to be finalized by ONC in 2022, the TEFCA will serve as a voluntary set of policies intended to work as an “on-ramp” to nationwide connectivity and data sharing across the care continuum.
With the TEFCA in place, much of healthcare will have both the means and opportunity to share data with other providers and patients with few barriers.
That is, of course, if you are one of the providers that is able to actually participate and benefit from these programs. As mentioned previously, not all provider types have benefitted evenly from programs and policies intended to drive better healthcare data sharing, with many still effectively locked out or with limited ability to meaningfully participate.
All the goals of advancing interoperability across the United States are laudable but will ultimately fall short of being revolutionary unless everyone is included in the interoperability conversation.
Healthcare as an industry must continue to push forward into the future, innovating and creating new technologies. While we do so, however, it’s crucial we raise the floor to ensure all provider types have access to this evolution of care. If all providers aren’t able to gain access to patient data, it ultimately is the patient who suffers as they must continue to navigate a partially interoperable health system without the complete seamless flow of data they were promised so many years ago.