Interoperability & Information Blocking: What Does It All Mean?
We are entering a new era of healthcare, one where the patient is empowered to direct his or her own treatment. Patients are more informed and involved in their care than ever before and app developers are tapping into people’s desire to be involved in the decision making when it comes to their care. They also expect to be readily provided with their healthcare information upon request, and legislation has been passed that will require such requests be fulfilled in a timely manner.
With the right technology and processes, however, interoperability and providing patient data can both be easily accomplished. In this blog, we will take a look at technology to aid in meeting interoperability requirements as well as offer a recap on information blocking.
Leveraging Apps for Interoperability
Apps today are leveraging the powerful computing technology that we all carry with us every day to make healthcare knowledge more accessible. The power of the smartphone is allowing developers to create apps that aggregate information about a patient’s healthcare, merge it with information about their habits and routines, and develop deep knowledge about what a patient’s issues are. There are apps that can analyze what is in a patient’s clinical records, break it down into layman’s terms and offer suggestions on care. There are also likely soon to be apps that can even guide a patient to the least expensive provider.
Direct Messaging & Interoperability
For years now, vendors have been encouraging users to share information with other providers through Direct Messaging to meet interoperability measures in the Quality Payment Program (QPP). Adoption of this method of information exchange has been minimal, largely due to the poor information quality of data exchanged through this method. However, upcoming changes will broaden and improve the quality of data submitted in this way and offer greater ability to exchange Electronic Health Information (EHI) through other electronic methods.
The US Core Data for Interoperability (USCDI) framework will greatly expand the amount of data that is available for both personal use and professional care coordination by allowing for the exchange of an expanded set of data classes. Information that was unavailable for exchange under the Common Clinical Data Set will now be transferrable and consumable electronically. Chart elements such as care plans and goals, as well as provider notes, will become available for seamless transmittal. Fast Healthcare Interoperability Resource (FHIR) APIs will make transmission of these elements simple, but they will also open new avenues of interoperability through FHIR-based apps as mentioned previously in this blog. You can review some currently available FHIR-based apps for both clinicians and patients via this link. The ability to use these apps seamlessly will open up to both providers and patients as vendors develop to the FHIR standards.
Preparing for the New Age of Patient-Controlled Healthcare
How do you prepare for the new age of patient-controlled healthcare? First, make sure that your software stays up to date. Failure to maintain interoperable software can result in greater difficulties for your practice as more patients request access to their data. Second, appoint an information and interoperability expert in your practice to remain abreast of rapidly changing regulations and requirements. The ONC Cures Act Final Rule website and the HIMSS Interoperability in Healthcare website are great sources of information. If you are a Nextech client, be sure that your expert is also signed up for the Compliance Newsletter where we keep our users informed on how the changing requirements will affect their software. Third, review your policies and procedures to ensure that you have processes in place to deal with patient and provider information requests. Train your staff on these procedures to ensure that no requests go unfulfilled.
What You Should Know About Information Blocking
Last year, the ONC released a new rule outlining the updates that EHR vendors must make to their platforms and receive certification for by early 2022, as well as electronic protected health information (EPHI) sharing requirements for providers. This rule is highly focused on allowing the free flow of information required for patient care between providers, as well as increasing patients' access to their own EHI. It accomplishes this goal by, among other things, updating EHI interoperability language to US Core Data for Interoperability (USCDI) and through requiring use of FHIR r4 APIs by EHR vendors. This will, in effect, make it so that disparate EHRs can trade data, and will allow for the electronic exchange of previously unavailable EHI content, such as narrative notes, vital signs and test results.
Since November 2, 2020, providers have been required to provide their patients with access to their records upon request and in a manner of which they are capable. As EHR vendors upgrade their systems to comply with USCDI, this information will become automatically available to patients via upload to the patient portal. If your EHR vendor has not yet made changes to support this, or if the patient requests a different method of note provision, you can still provide it in another manner that is acceptable to the requesting patient. For more details as well as a list of exceptions to the Information Blocking rule, check out this past blog post.
The landscape is changing quickly, but by staying informed of changes as they happen and adapting your practice’s processes as necessary, you will be able to ensure your practice is prepared for the new world of patient-controlled healthcare.
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About Courtney Tesvich
Courtney Tesvich serves as Nextech's VP of Regulatory and Compliance.