Pew Urges ONC, CMS to Support APIs to Boost Patient Data Exchange

The Pew Charitable Trusts penned separate letters to the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) to support patient data exchange through the use of application programming interfaces (APIs).

In its letter to ONC, Pew and 13 other organizations urged the agency to not further postpone its information blocking and health IT certification rules, which were delayed in October 2020 due to COVID-19.  

The ONC final rule requires medical providers and device developers to promote patient data access using APIs and third-party apps.

APIs aim to boost interoperability and support the patient access, exchange, and use of electronic health information. Clinicians can also utilize APIs to integrate decision support tools to create targeted treatment plans.

“With the ongoing COVID-19 outbreak, more patients and providers are relying on telemedicine to meet healthcare needs and patients can no longer pick up medical records in person to transfer them to other facilities,” wrote Pew. “The new regulations—finalized earlier this year to implement provisions from the 21st Century Cures Act (Cures)—to promote data sharing play an essential role in making health records more accessible to patient and health care providers to improve the continuity of care for patients.”

ONC delayed the information blocking provisions and requirements compliance date to April 5, 2021. The 2015 edition health IT certification criteria updates and the new standardized API functionality dates are now required by December 31, 2022.

“By committing to enforce the API requirements according to the timelines currently proposed, the administration can provide patients, technology developers, and health care providers with clarity on the evolution of health information technology capabilities and ensure that data is made available when and where it’s needed,” wrote Pew.

In December, CMS proposed a new rule to help boost patient data exchange by developing APIs.

This proposed rule intended to build upon the CMS interoperability rule by increasing interoperability and patient data access.

Effective patient data exchange and improved interoperability can also help minimize the spread of the coronavirus. Providers with seamless access to patient information are better equipped to deliver high-quality COVID-19 treatment. Better interoperability may also assist public health agencies.

CMS said the proposed rule would force Medicaid, CHIP, and QHP payers to develop APIs to back patient data exchange and prior authorization. Payers across the country would integrate the APIs using the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard. As noted, ONC originally proposed to adopt this standard for the interoperability rule.

If passed, this rule would require payers to integrate an FHIR-based API to streamline patient data exchange. Patients would have full access to their medical histories and bring this data from one payer to another.

The rule would also allow providers to improve patient care and spend more time with their patients. Furthermore, it would request more information on social determinants of health (SDOH).

“Pew calls on the agency to use the regulation to expand the ability of both providers and patients to access and share information in electronic health records,” wrote Pew.

The organization recommended CMS refine the rule to further streamline patient data exchange. Pew said CMS may consider:

• Integrating API metrics to see the number of patients accessing information and detailed individual characteristics to potentially identify data disparities
• Providing patients with information on how their data are used
• Implementing standardized codes to boost interoperability
• Increasing the types of data individuals can access through APIs
• Identifying SDOH policies with patient security and security in mind

“This proposed rule includes several provisions that will make health data more accessible and available to patients and clinicians,” concluded Pew.