The Office of the National Coordinator’s New Interoperability Rule and its Relationship to EHR Mandates

The Office of the National Coordinator (ONC) recently passed the 21st Century Cures Act and the CMS Interoperability Final Rule, which will give both patients and health care providers secure access to personal health information. Under this new rule, companies in the health care industry are encouraged to install standardized Application Programming Interfaces (APIs) that give patients access to their health information from a mobile application.

But what do these new rules mean for EHR mandates? How does the health care system as a whole improve from them? In our latest article, Iron Bridge examines the 21st Century Cures Act and Final Rule as well as their impact on EHR mandates.

The Impact of Current EHR Mandates

Learn Why EHR Mandates Are Important for Patients and Their Communities

Many patients and physicians initially feel wary about storing sensitive health data onto a cloud-based system. To ensure the safety and protection of this information, CMS payers are required to follow a set of EHR mandates.

These guidelines are designed to:

• Engage both patients and families in their health care
• Ensure the privacy of patient health information found in the EHRs
• Improve public health management and services
• Reduce health disparities among different members of the community

Due to the rise in use of EMR/EHRs, many health care professionals are on the search for innovative technologies that follow these mandates and improve upon the current technology for managing patient records.

The Cures Act and Interoperability Final Rule

Everything You Need to Know About the New Act

The Interoperability and Patient Access Final Rule can be summed up rather quickly. Essentially, the rule requires CMS-regulated payers to utilize APIs and FHIR technology to give physicians and patients better access to their health information. CMS-regulated payers include Medicare Advantage organizations, Medicaid Fee-for-Service (FFS) programs, CHIP FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers.

Using HL7 FHIR 4.0.1. these APIs must allow users to access their claims, payments, and health information through third-party apps. Payers should also make their provider director information publicly available to viewers through a FHIR-based Provider Directory API. CMS-regulated providers must implement these requirements in increments between now and April 2022.

Choosing an IT Solution for Following the New ONC Rules

So how do these new laws affect a payer’s current ability to follow EHR mandates? They essentially aim to make Electronic Health Records more accessible to both physicians and patients. With easier access to electronic health records, physicians can improve patient outcomes as a result of reducing medical errors, increasing the efficiency of care, simplifying administrative tasks, and encouraging patients to become more involved in their health care decisions.

When it comes to deciding how to overhaul current systems to make them abide by the new ONC rule, EHR vendors are often stuck between building their own technologies or purchasing ready-to-use FHIR API. Payers who choose to build their own FHIR APIs often end up paying a hefty bill for the creation and long-term management of their custom-build systems. That’s why many payers end up looking into purchasing ready-to-use FHIR APIs instead.