All healthcare providers in America must make electronic health information sharable by October 6, 2022, in a rigorous implementation of the ONC Interoperability Rule. The Office of the National Coordinator for Health Information Technology, abbreviated ONC, is an entity within the U.S. Department of Health and Human Services (HHS).
In 2016, Congress passed the 21st Century Cures Act which became the impetus behind making patient health data electronically accessible. The Cures Act Final Rule was announced in 2020 and has a provision for making patient data transferrable across healthcare platforms and to patients’ smartphone devices as well, at no cost.
EHR Interoperability gives patients more choices in their healthcare by not making them locked into one provider. Making health data available across different vendor platforms as well as patient smartphone devices has many challenges. The foremost is the necessity for the healthcare industry to adopt standardized APIs in healthcare (application programming interphases) that facilitate information exchange.
What the Cures Act Final Rule means for clinicians
Since the Cure Act Final Rule specifically pertains to the interoperability of EHR systems, it means that the EHR of one provider should be able to electronically transfer data in a safe and secure way to another provider’s system. The act also defines information blocking and the penalties that can accrue from it as well as the exceptions where information blocking is allowed. If a practice has data that is not ‘liquid’, it could be considered a data blocker under the Cures Act.
39% of Health Providers surveyed say they are unaware that they could incur civil monetary penalties for information blocking practices – Life Image Survey 2021
Challenges implementing EHR interoperability and how to overcome it
The necessity for software vendors to make their platforms interoperable is very clear. However, while the need is understood, many existing EHR solutions might not be built for interoperability.
A survey sent out in March 2021 to 4,000 technology and administrative leaders in the healthcare sector in the US indicates that many organizations do not meet even the basic interoperability standards. These are the challenges that many clinicians face with their EHR systems:
1. Inconsistent data formats that cannot be recognized
Many EHR systems may possess foundational interoperability i.e a direct data exchange channel can be set up between different EHR systems. However, the data cannot be automatically processed. For instance, if an OTC medication prescription is sent across in a pdf format, the receiving system can store the information but cannot act on it. This basic level of interoperability in healthcare does not expedite the diagnostic process.
66% of healthcare organizations say that they still use paper rather than digital solutions to share healthcare data with patients. – Life Image Survey 2021
Solution: Consider software upgrades that can consistently pull data from different silos and convert them into uniform data sets that can be recognized across networks. For instance, DocExtract, the AI-driven document digitizer from iTech can convert physical documents as well as unstructured digital documents into structured data. Now think of this in actual application – if a pharmacy system uses the same data structure format as the medical practice it can receive and process medication lists. This is called structural interoperability which is an important step up from the basic foundational interoperability.
2. Security and privacy concerns in sharing sensitive data
The Cures Act Final Rule’s requirement is that patients get on-demand access to the information within their medical records. This throws up a complex issue on data privacy. When is it okay to respond to electronic requests for patient information?
Solution: From the technology standpoint, you will need an EHR solution that verifies the data requests and uses an OAuth 2.0 authorization protocol to permit or deny electronic requests to access data as well as limit what data can be shared. To explain this further, when a healthcare app requests permission to access clinical data, there are predefined authorization limiters that will decide what data the third-party request needs. iTech uses HL7, a set of international standards for de