July 20, 2020

Interoperability Rules Are Delayed: Why That’s Good News And Bad News

In April, the Centers for Medicare and Medicaid Services (CMS) announced they would delay the enforcement of its Interoperability and Patient Access Final Rules until 2021.


This is a good news/bad news scenario for healthcare providers and the health IT professionals who support their clinical workflows. The good news: It gives IT staff six more months to create, test and deploy the infrastructure that supports Patient Access and Provider Directory APIs, pushing forward toward true interoperability in a way that ensures the secure and effective transmission of patient data.


The bad news? These exact measures would be exceedingly beneficial during the extraordinary circumstances of the pandemic.


Secure sharing of patient health information (PHI) is only possible if the providers involved in the exchange of that information are on equal technological footing. It’s for this very reason that the FHIR standards were established. They provide guidance on the APIs developers should utilize in order to ensure that two disparate systems are able to communicate with each other.


Without this guidance, and without true interoperability, one of two things can happen. The first is that there’s a significant delay in transmitting PHI between providers. If a physician’s office or hospital is not up to date with the latest iterative standards, either the recipient or the sender must come up with a workaround to accommodate the other party.


Second, the recipient could get an incomplete picture of the patient’s health. Typically, this is something that occurs when a patient has a healthcare encounter with numerous providers, each operating on a different electronic health record (EHR) system or, worse, not using an EHR at all. If just one of those providers isn’t adhering to interoperability standards, information from that encounter might not move downstream to the newest provider.


So the risks are: a delay in information receipt or an incomplete picture of a patient’s health record. Either one is unfortunate; both happening at once is particularly odious. Even during normal times, this situation is unfortunate, but during a pandemic? It can be a calamity.


During a crisis like the one we’re facing right now in healthcare, the IT applications and software that make interoperability possible are more important than they’ve ever been. Secure transmission of all applicable patient health data ensures that all providers have an accurate, up-to-date window into a patient’s past and current status. This allows them to make the clinical decisions necessary to guide the care of all patients, including the critical decisions that need to be made in COVID-19 cases.


Interoperability also comes into play when you think about the effect quarantine has on healthcare provision. Around the country, family members aren’t able to enter rooms to be with patients — and the same goes for nonessential staff. Interoperability ensures that a patient’s health record can be securely transmitted to all approved parties even offsite.


Another aspect of CMS’s interoperability push that can’t be ignored is the current administration’s MyHealthEData initiative and its intent to eliminate the concept of data ownership. CMS has been vocal about the concept of patient data belonging to the patient, promoting the development of Patient Access APIs and the concept of portability to ensure a patient has access to their health record and can take it with them to subsequent healthcare encounters.


One can see how, in the midst of the pandemic, this portability is vital. As a patient transitions between care settings based on his or her level of acuity, they may encounter a variety of providers relying on various EHR systems. If the patient and their family are able to track their health information between those settings, that’s yet another assurance that the provider is acting upon the latest available clinical and diagnostic data.


In all these ways and more, interoperability can enable healthcare providers to do their best, most accurate work in the throes of the ongoing crisis. So while the delay of interoperability rules is fortunate in one respect, in that it frees up IT teams to support their clinical staff in ways more directly related to triage and other frontline primary care, it also removes any incentive for prioritizing the very type of interoperability that would come in handy right now.


I’ll leave you with this: Supporting frontline clinical staff is the most important goal for anyone in healthcare today. But if you have the resources to continue pursuing interoperability policy, then delay in the enforcement of the rule shouldn’t dissuade you from staying the course and continuing your push to interoperability in the current environment.


Originally posted on Forbes Technology Council (view original).