If there is one thing we all can agree about the new COVID era, it is how we as humans continue to evolve and adapt. COVID has also made us realize the importance of having access to our health data and the seamless exchange of data between patients, providers, and payers. Just like the COVID vaccine though available, is of little use until l it gets administered into people’s arms, similarly the health data, though available, is not of much use until it gets into the people’s hands in a meaningful way. This is where the participation of Payers, Providers, and Health IT vendors becomes vital.

Earlier this year, there were two regulations released that will change how providers, payers, and patients are required to exchange health data. The two rules, issued by the Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS), implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act. ONC’s final rule establishes secure, standards-based application programming interface (API) requirements to support and promote patients’ access and control of their electronic health information. The recently released Interoperability and Patient Access final rule (CMS-9115-F) by CMS confirms that Medicaid, the Children’s Health Insurance Program (CHIP), Medicare Advantage (MA) plans and Qualified Health Plans (QHP) will be required to make enrollee data immediately accessible by 2021. The Interoperability and Patient Access final rule delivers on the administration’s promise to put patients first, giving them access to their health information when they need it most and in a way that they can best use it. CMS has led by example by successfully leveraging the Fast Healthcare Interoperability Resources (FHIR) standard to implement a large-scale data sharing initiative known as Blue Button 2.0. Under this initiative, Blue Button 2.0 uses a FHIR API to deliver four years of Medicare Part A, B and D data for over 60 million Medicare beneficiaries. 

We at Darena Solutions, are playing our part in keeping the FHIR momentum going, by getting health data to patients through multiple projects and initiatives. We allow patients to become their own data aggregators and make it easy for them to collect, manage, use, and share data with their caregivers. In this blog, we would like to summarize our thoughts from the entire year to remind everyone that regardless of the role you play in the healthcare ecosystem (patients, providers, health IT vendors, and payers), come 2021, you need to start playing with FHIR.  

Taking stock of recent developments in the Healthcare IT marketplace, it is fair to say that FHIR adoption is spreading like wildfire. Don’t just take our word for it. Take a look at what the top technology companies such as Microsoft, Google, Apple and Amazon are  doing to fuel the FHIR, all with the common goal of liberating healthcare data and utilizing it for better patient  outcomes at lower costs.   

Involvement of these Tech Giants might have you wondering What is really different about FHIR? Truth be told, it is simply the uniformity of data that FHIR brings. Don’t get us wrong. Healthcare does need a healthy dose of innovation and unique approaches. However, health data format is not one of them. The sheer variety of health data formats that exist in healthcare IT has been the primary obstacle to healthcare interoperability and by extension the biggest deterrent to innovation that leads to reaping the benefits of unified data. FHIR finally removes this barrier by leveraging standard technology practices followed industrywide and bringing them to healthcare. For instance, this democratization of healthcare development will not only reduce the development costs for EHR vendors, but will also allow them to respond to the unique needs and challenges of providers in each specialty with a simple answer – “there is an app for that”.  

In the world of value-based-care, FHIR can prove to be especially powerful in streamlining existing workflows and data utilization issues that healthcare providers are faced with. They no longer need to be torn between providing best care to their patients efficiently and meeting the reporting requirements. FHIR has the power to be that magic box that can ease the pain caused by juggling with multiple data format requirements that co-exist while transitioning from one EHR edition to the other. FHIR can significantly improve the EHR workflow by capturing the right information at the point of care, support the APIs, and meet MIPS reporting requirements at the same time. The benefits of FHIR are not restricted to the Providers. The health data, made available by FHIR creates new opportunities for registries and research organizations to receive health data directly from the patients which can be used to develop new care guidelines leading to improved healthcare delivery and outcomes.

At the end of the day, healthcare is all about providing better care to patients. While getting better tools helps providers, FHIR also matters for the patients as each of us is a patient at one time or another. Increased interoperability benefits the patients (all of us) greatly. When FHIR is the common language that all our providers and payers speak, it is possible to gather data from all of them (primary care physicians, specialists, hospitals, Medicare, and all Commercial payers) in a single repository you could call your Personal FHIR Record (PFR). PFR gives you complete control over your data. You decide what data you share and with whom. This can be of tremendous value to adult caregivers who can easily store the health data for their loved ones in a centralized repository and transport data between appointments and providers easily, eliminating the time-intensive phone calls and records requests. In case of emergency, aggregated data powered by portability and interoperability can be a lifesaver.    

So, is there a downside of FHIR and putting health data in hands of the people who are its rightful owners? What about HIPAA, security, and privacy? These are all valid concerns shared by financial institutions and banks as well. If they can rely on Open Authorization (OAuth) to mitigate this risk and protect their customer data, why can’t healthcare? There is no denying that healthcare data is subject to an increased security risk, but we cannot let certain entities adopt a paternalistic attitude and obstruct the right to our own data. A lot of thought has gone into the 21st Century Cures Act with data security being one of the primary concerns and that’s why FHIR API requirements were put in place to ensure that no health data is shared without a patient’s consent. Once patient consents to share their health data with an entity, HIPAA does not apply. We have debunked this myth of data privacy risk and explained it at length in our blog in response to Epic’s argument for privacy concerns.  

As FHIR catches on, it is important to understand what the right solution is for you. We believe the mark of a progressive solution is adaptability. A solution that not only meets the current functional and regulatory requirements but also addresses future needs while accommodating every provider organization’s overarching mission of providing better quality care. If we lived in a fairytale, health organizations could have used a magic mirror to tell them which solution is the FHIRest of them all. As we do not, we have outlined the logical steps that you could use to find the right Cures Act compliance solution for your organization.  

At Darena Solutions, we believe in going above and beyond the requirements. We see achieving compliance as a part of the journey, a mile-marker, not the destination. We have already taken our first step in this journey to unlock healthcare data and improve patient access, and quality of care. Our BlueButtonPRO was one of the first apps to be approved by CMS to support the Blue Button 2.0 initiative and enable Medicare beneficiaries’ access to their healthcare data. We also became the nation’s first ONC-certified FHIR-based solution that not only meets but exceeds the 21st Century Cures Act requirements. 

To truly unblock and unleash the power of health data, the providers, payers, EHR vendors, and App developers need to gather around FHIR and begin playing with it. Together, we can bring about meaningful change to the lives of our loved ones, our friends, our colleagues, and ours. COVID has shown us how small actions like staying home and wearing a mask can have a cascading impact on our lives. Let us extend that to enabling access to healthcare data. FHIR is the surefire way to speed things up. Whether you are an EHR vendor looking for a module to become Cures Act compliant, a Payer looking to meet impending CMS-9115-F requirements, or a Provider looking to avoid Information Blocking penalties, we are excited about working with you. 

FHIR gives us similar optimism by enabling players in the healthcare ecosystem to empower patients with their health data.

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