On the Highway to Cures Replace: Licensed API Expertise

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The moments we’ve all been ready for since 2016 are quick approaching: the 21st Century Cures Act infrastructure is coming into place in 2022! The Cures Act laid out a imaginative and prescient for a wealthy well being IT ecosystem of standards-based APIs and nationwide well being info networks to securely open up electronically accessible info to sufferers themselves and to well being care professionals supporting their care. As we’ve mentioned in earlier blogs, progress on nationwide community integration through TEFCA continues apace, and beginning on October 6, all actors coated by the knowledge blocking provisions of the Cures Act shall be required to make obtainable the total scope of electronic health information to different approved events. On this weblog, we’re going to give attention to the upcoming deadlines for availability of standards-based FHIR APIs.

There was great business adoption of FHIR, so it might be shocking to many who this progress has occurred although regulatory necessities for licensed expertise builders to deploy customary FHIR APIs have nonetheless not absolutely gone into impact. That modifications this 12 months, nonetheless, as a result of the ONC Cures Act Last Rule requires that licensed well being IT builders replace and supply their clients with FHIR-based application programming interfaces, also called licensed API expertise, by December 31, 2022.

We’ve been intently monitoring licensed well being IT builders’ progress in updating their expertise to be licensed to the Cures Update criteria, specifically, §170.315(g)(10) Standardized API for patient and population services. As of August 1, roughly 5 p.c of licensed well being IT builders have up to date their expertise to licensed API expertise. Nonetheless, these 5 p.c assist roughly 66 p.c and 77 p.c of the in-patient and ambulatory customers with their Well being IT Modules nationwide, respectively.

Figure showing the progress of Certification to the 2015 Edition Cures Update Criteria to be available by December 31, 2022

Determine 1  Information Supply: Licensed Well being IT Product Listing (CHPL). Percentages signify the licensed well being IT modules (i.e., product variations) compliant to a 2015 Version Cures Replace criterion so far as a proportion of the general variety of modules required to be compliant to that criterion (n) by December 31, 2022. Be aware the CHPL knowledge relies on at present energetic licensed well being IT modules required to replace.

Market Share of (g)(10) Compliant API Developers

Determine 2 Information Supply: Licensed Well being IT Product Listing (CHPL); Medicare Selling Interoperability Program. Percentages signify the proportion of the hospital and clinician person base with a licensed API product whose API developer has a licensed API product compliant to the (g)(10) criterion. Be aware the CHPL knowledge relies on at present energetic licensed well being IT modules required to replace, and the Medicare knowledge displays 2019 program reporting.

Whereas many licensed well being IT builders have but to certify their API expertise to the brand new FHIR standards, these with giant user-bases have already got, so it’s seemingly that these customers shall be supplied with up to date expertise properly earlier than the December 31, 2022 deadline. Additional, the 2022 Standards Version Advancement Process (SVAP) now contains the HL7® FHIR® US Core Implementation Guides 4.0.Zero and 5.0.1, which some well being IT builders had been ready for, and we anticipate that many well being IT builders will now transfer ahead to assist these newer implementation specs to certify to the FHIR-based API criterion.

Along with technical specs, Certification Program necessities additionally embrace “Circumstances and Upkeep of Certification” for APIs, which set necessities for licensed well being IT builders in areas equivalent to transparency, charges, and market competitors. Which means that as a clinician or well being care supplier you’ll have:

  • Flexibility to attach apps to your current licensed well being IT with outlined timelines for licensed well being IT builders to register apps;
  • Access to standardized electronic health information by means of the USCDI v1 and, in case your licensed well being IT developer selected to undertake it, USCDI v2;
  • Better transparency into your licensed well being IT developer’s enterprise and technical practices, equivalent to charges, to deploy apps in manufacturing environments.

A nationwide ecosystem of normal FHIR APIs will allow extra innovation and options developed by business and cut back one-off interfaces, leading to decrease interoperability prices sooner or later. Eligible hospitals and Essential Entry Hospitals collaborating within the Medicare Selling Interoperability program, and eligible clinicians collaborating within the Selling Interoperability efficiency class of the Benefit-Based mostly Incentive program, shall be required to make use of licensed expertise up to date with the 2015 Cures Replace (together with FHIR APIs) for efficiency durations beginning in 2023, as famous within the lately launched Physician Fee Schedule proposed rule.  To additional assist the diffusion of API capabilities, TEFCA has a FHIR Roadmap explicitly timed to observe quick on the heels of the FHIR API deadline in early 2023 to catalyze nationwide scalability of FHIR-based capabilities.

As famous earlier, licensed well being IT builders are required to replace and make obtainable to their clients customary FHIR APIs by the tip of 2022.  If you happen to use a licensed EHR and don’t but have a typical FHIR API obtainable, we encourage you to contact your vendor to study extra about their plans to offer you a licensed API by the tip of 2022 and allow you to totally take part in our 21st century digital healthcare future.

For added info and sources on the advantages of the 2015 Version Cures Replace, try a lately revealed Cures Update fact sheet. We encourage all stakeholders to familiarize themselves with the small print offered on this reality sheet, and we welcome questions by means of the ONC Health IT Feedback and Inquiry Portal.

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