Would Health IT APIs Become a Public Utility under the ONC’s Proposed Rules?

The Cures Act directs the Office of the National Coordinator for Health IT (ONC) to implement Conditions and Maintenance of Certification that require EHR vendors to provide open APIs without special effort.  In its proposed rule, the ONC not only proposes technical standards and technical outcome expectations to facilitate access, exchange and use of electronic health information using FHIR-based APIs; it also takes direct aim at rent-seeking business practices and behaviors that it believes interfere with data interoperability.  This blog reviews the ONC proposal to restrict the fees that health IT developers would be permitted to charge for certified API technologies they offer in the marketplace. Background The ONC’s proposal to regulate fees on API technology would apply to EHR vendors, which would be required to implement the certification criterion for a proposed FHIR-based “standardized API for patient and population services” within 24 months after final rules take effect.  Other health IT vendors have the option of presenting API technologies to the ONC for testing and certification under the ONC Health IT Certification Program.  API Technology Suppliers with certified API technologies would be subject to the Conditions and Maintenance of Certification proposed as a new subpart D to 45 C.F.R.…

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Summaries of the ONC’s Proposed Data Interoperability Rule

A GitHub repository to display high-level and selectively detailed summaries of the ONC's proposed rules is live.  If you've never used GitHub, it's a great way to start collaborating in the software developer community.  If you already use GitHub, the summaries are an invitation to collaborate and engage with you about the ONC's proposals for data interoperability. To access GitHub, you first need to register an account.  After that, click on either of the links in the first paragraph  to begin reading the summaries.  Not all sections of the proposed rule have been summarized, but more of them will be over time.  Meantime, feel free to contribute! Follow links in the Table of Contents to sections that have been summarized. Also, the ONC has provided informal resources on HealthIT.gov to help the public better understand the proposed rule.  The ONC's presentation to HIMSS about the Proposed Rule is a good starting point. The comment period is open until 5pm on May 3, 2019. If you want to submit comments, go to the Federal eRulemaking Portal and upload your comments in MS Word (preferred), MS Excel or Adobe PDF.  If you want help with analyzing any portion of the rules, or…

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With Recent Rulemaking, the ONC and CMS Give Digital Health Innovators A Map for the Emerging Data Interoperability Highway

On February 11, 2019, the Office of the National Coordinator for Health Information Technology (ONC) released its Notice of Proposed Rulemaking for implementing data interoperability provisions of the 21st Century Cures Act.  Under the proposed rule, all health information technology (HIT) vendors that sell “certified electronic health record technology” (CEHRT) to health care providers will be required to meet new security, data governance and API standards, once final rules take effect.  The proposed rule also describes steps to end business practices that emerged during the years when electronic health records were being adopted, which Congress viewed as anti-competitive. In a related announcement, the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule to promote data interoperability by health plans that participate in the Medicare, Medicaid or the CHIP program, or that issue qualified health plans in the individual health insurance marketplace. Both proposed rules mark a long-awaited step towards standardizing the rules of the road for data interoperability in healthcare.   Of course, the industry hasn’t been sitting on their heels.  Epic’s App Orchard, Xealth’s API marketplace and Apple Health Record are examples of the kind of tracks that are already being laid to connect consumers with their health…

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Is It Too Soon for Blockchain in Healthcare?

Blockchain generates a lot of hype and more than a little notoriety because of its ties to cryptocurrencies. While the healthcare industry understandably seeks to avoid hype and notoriety, and mostly waits for emerging technologies to prove themselves in other industries, ignoring blockchain would be a mistake. The main reason is that it alters the strategic mindset: It offers a fresh perspective for solving some of the vexing business challenges in health IT. In a fragmented health system, the business challenges swamp the technical ones. An example of how blockchain alters perspective is illustrated in a new white paper, Crowdsourcing Provider Directory Maintenance, written by a team led by Kyle Culver of Humana and Andrew Beal of Ernst & Young. Kyle was one of the winners in the 2017 Blockchain Challenge sponsored by HHS’ Office of the National Coordinator for Health IT. In the paper, the authors examine how to keep provider directories current through a blockchain lens. In setting up the problem, the authors observe that health plans currently manage separate provider directory silos that are rife with inaccuracies. Provider demographics can change so rapidly that it is hard to keep these directories up-to-date. I’ve seen how quickly the…

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