Electronic Health Reporter

By Scott Galbari, chief technology officer and CISO, Lyniate.

For as long as healthcare data has existed, so has the healthcare industry’s challenges with interoperability. The pursuit of healthcare data interoperability has been a longstanding industry challenge, and with the recently finalized interoperability rules from the ONC/CMS going into effect at the end of this month (though deadlines will be extended until mid-2021), interoperability yet again is at the center of many healthcare discussions.

The rules, which aim to provide patients with greater control over their health data and eliminate information blocking, has not been without its critics. Some argue this rule will put patients at risk by inadvertently exposing patient health data to security breaches. However, the spread of the coronavirus pandemic across the United States has underscored the dire need for seamless, bi-directional data exchange. The new rules’ focus on FHIR and APIs to enhance electronic health information sharing are proving to be exactly what we need in the current crisis.

The coronavirus has necessitated all kinds of changes — from rapidly escalating the use of telemedicine, to standing-up temporary testing sites and care centers, to meeting enhanced public health reporting requirements — all of which would have been much more easily addressed if the new rules’ requirements were already in place, and all of which have presented significant challenges amid the COVID-19 crisis.

Because of these unprecedented circumstances, healthcare stakeholders are being required to share health information and data at increasingly high volumes, emphasizing the importance of strengthening the internal infrastructures of these organizations to ensure they can properly send, receive, and analyze health information. However, because of the strain COVID-19 has put on healthcare organizations, the Department of Health and Human Services (HHS) has decided to push out the timeline for meeting the rules’ requirements. While the reasoning for this is understandable, in many ways it is unfortunate that these requirements were not already in place prior to the pandemic.

The new rules put a big emphasis on data portability, API compliance, and patient data access —  all of which are more necessary than ever in the context of COVID-19. With the pandemic necessitating pop-up testing sites, alternative care settings, and the use of telemedicine portals, it is vital that healthcare organizations give immense consideration to meaningfully sending and receiving data in and out of these emerging infrastructures.

APIs and the FHIR standard are huge components of the ONC and CMS rules due to their ability to strengthen data portability. When put through the lens of the coronavirus pandemic, it’s easy to see how this level of interoperability would be so impactful to the current situation. With more care happening outside the hospital, COVID testing taking place in pop-up testing stations, and the expectation from government entities that healthcare organizations will readily share patient data to track and control the spread of the virus, implementing organization-wide integration technology can help organizations meet the demands of both COVID-19 and the ONC and CMS rules.

Additionally, with the rapid increase in health organizations utilizing virtual care technology, provider organizations are struggling to efficiently connect with new entities, new locations, and new IT systems. This fact underscores the critical need for more robust fundamental interoperability infrastructure to support virtual care.

Virtual care has many benefits — like limiting points of contact, reducing time spent in appointments, and faster more efficient care — but because so few health organizations have been able to prioritize wide-spread interoperability initiatives, it is presenting great difficulties amid an already challenging time. Until recently, the healthcare system has been preoccupied by the pandemic with much of the rest of the population’s healthcare needs having been put on hold. However, routine care that has been delayed for months is now surging back, making strong infrastructures all the more necessary to support the urgent demand.

The difficult circumstances of the coronavirus and the lofty expectations of the new rules in many ways make for unstable conditions across the industry. However, they are both pushing the industry toward some necessary and long overdue improvements, such as strengthening the infrastructures of healthcare organizations to be able to manage the adoption of new technology, and scale it to meet demands — whether it’s sharing health information with public health offices or transitioning patient files between providers.

It’s been a long-held view by Lyniate that healthcare leaders need to consider interoperability a necessary fundamental organizational capability that will reap positive benefits across all departments. Data portability and bi-directional data exchange are not truly possible unless data integration is prioritized across silos— not just within the silo. Interoperability should be a strategic initiative for healthcare organizations, and the current, unfortunate circumstances of COVID-19 emphasize how vital interoperability is to the health of healthcare organizations, patients, health systems, and public health.

Flexible information sharing is now more important than ever as healthcare providers work to ensure patients are well-cared for during this global health crisis. With telehealth tools, and other forms of alternative care and testing sites rising in popularity, healthcare leaders must implement solutions that ensure data is shared with the appropriate stakeholders across the care cycle. The new rules focus on freeing data that will help patients get better access and control of their data, and they will enable healthcare providers and public health agencies to better track and understand the spread of disease throughout this and any future pandemics.