When the UCSF Center for Digital Health Innovation was established in 2012, we saw the availability of healthcare data and ease of exchange as one of the critical hurdles to overcome to enable digital innovation. We knew then that healthcare was lacking standard API’s for healthcare data interoperability, and we immediately saw the value and applicability of a promising standards proposal created by a group within HL7, called Fast Healthcare Interoperability Resources (FHIR). FHIR utilized modern API’s based on REST and XML/JSON which CDHI believed necessary for digital health innovation, and since its inception, UCSF has created several digital health apps that utilize FHIR. Today FHIR continues to improve with increased maturity, adoption, and engagement, and CDHI continues to explore how these improvements can be leveraged to improve digital patient care.
Five years into the nation’s 10-year interoperability roadmap, where do we stand? For new draft regulations just out from the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS), what is our polestar? Are we halfway there yet?
Let’s start with a prediction: By 2025, everyone with diabetes will be tracking their blood sugar with devices called continuous glucose monitors, and it will be common for many people without diabetes to dabble in tracking, too.
Over the past decade, our patients have had increasing access to their own health data via electronic patient portals. Now, in an exciting transformation in health care, patients are shifting from simply accessing their health data to more directly managing and using it to improve their health and care.
Interoperability is a national priority precisely because no single vendor EHR system is comprehensive, and there must be interoperability across myriad data types, sources, authorized users, and use cases. Given this, we say “connected health record,” not comprehensive health record, and we are not alone.
We appreciate the recent perspectives published in the New England Journal of Medicine on the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the positive impact that it and resulting health IT policies have had on U.S. health care.1,2 The perspectives highlighted the remarkable increase in adoption and use of electronic health records (EHRs) over the past eight years, thanks to the HITECH Act and to ONC’s and CMS’s implementation of it with major advice and help from the multi-stakeholder HIT Policy and Standards committees.
The National Quality Forum today released a comprehensive framework to measure and assess the nation’s progress toward interoperable electronic health information exchange. This landmark work by NQF and its Interoperability Committee provides critical support to national efforts to improve interoperability and advance the Triple Aim for better health, better care and better value.
By a vote of 392-26 in the House of Representatives and 94-5 in the Senate, Congress passed the 21st Century Cures Act and directed that interoperability and patient access are national priorities for electronic health information exchange and better health, better care and better value.