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>> Hi, I'm Doug Seven,
Senior Director at Microsoft Health Next.
Welcome back to our video series on the Azure API for FHIR.
In the last video,
we looked at the role of FHIR in modern health systems.
In this video, I want to talk about the role of
United States legislation in
advancing the use of FHIR across health IT.
In this case, we're going to be talking about
the impact of what is known as
the ONC Final Rule as part of the Cures Act.
As mentioned before, we've seen
the growth in the digitization of health IT,
which has been tremendous for the ability to
access information in a digital form.
This is great at the point of care within a single health network,
but it's been a real struggle for organizations when
they're thinking about how to get data from other systems,
how to exchange data between different provider networks.
Anybody who's moved or switched providers in the United States,
has probably experienced this situation.
If you move across the country,
you need to switch your healthcare providers
to new providers where you live,
and oftentimes, it can be challenging to get data from
your previous health care providers
transferred over to your new health care providers.
In some cases, you might just be working with
different providers in different health care networks
in your same city, and they can often be difficult
for them to exchange information.
The systems aren't designed for this interoperability,
and so the state of the art often is sending a paper
request to one provider to have them
fax information to another provider.
This can be very challenging,
as well as detrimental to the care of patients.
The ONC Cures Act final rule,
is designed to give patients and their
healthcare providers a secure access to health information.
It aims to increase innovation and competition by
fostering an ecosystem of new applications,
to provide patients with more choice in their health care.
This final rule includes a provision that requires that
all patients can electronically
access all of their health care information,
whether it's structured or unstructured data.
This will be at no cost using an application of their choice.
This is really critical because what
the final rule then defines is,
that all electronic health information
needs to be programmatically accessible
to both health care providers for the purposes of care,
and to patients for the purposes of access to their own data.
The Final Rule has impact on
a number of different constituents in the role of health care.
If we start by thinking about patients,
the Final Rule says that patients
get ease of access to their data,
they get to access that data
programmatically through applications of their choice.
This is tremendously important,
as a patient having a right to have access to my data and to be
able to get that data programmatically
using a variety of applications,
will create a rich ecosystem of
new applications from new vendors available to me.
From a provider or clinician standpoint,
this means that I need to make data requests
easy and inexpensive because I have to make
this data freely available to patients.
I have to do this in such a way that I
support a choice of applications.
It can't just be through a proprietary application,
but I have to expose this data in a way that
makes it available to many applications,
and I have to do this in a compliant and secure way.
For health plans or health payers,
there's also rules being adopted by
the Centers for Medicare and Medicaid services
in support of their incentive programs.
Health plans also need to implement patient to
access APIs and Provider Directory APIs to
programmatically provide access to that data as well.
All of this is hugely important,
as it means that this legislation of the final rule,
is promoting the use of
digital health care data across an ecosystem.
Now, the interesting part of the rule here is,
that the rule had to make a decision on what the standards
were for the exchange of this data so
that all of these systems can work together.
The final rule specifies FHIR R4
as the implementation specification.
In other words, patient access APIs, data APIs,
different app ecosystems, will all be supported through FHIR APIs.
The ONC has published a timeline for
the implementation of the final rule
and the implementation of
the FHIR based APIs that will support the Final Rule.
The effective date of the timeline is June 30th.
In other words, that's when the timeline really begins.
Then, there's key dates throughout 2021, 2022,
and some final dates in
2023 for the implementation of these systems.
This is really important because it means that
healthcare providers and healthcare payers are on
the clock in terms of getting their support for
the ONC Final Rule in place in support with FHIR APIs.
Some of the key deadlines begin as early as April 5th, 2021,
and by the end of 2021,
we should see most health care providers and
payers having these APIs in place.
By the end of 2022,
it's mandated that all HL7 FHIR APIs be available and ruled out.
In this module, we looked at the impact of
the ONC Cures Act Final Rule,
on the implementation of FHIR across the health ecosystem.
This is really important because
this rule essentially makes FHIR the de facto
standard for the exchange of health information
across systems in the US health care system.
It's likely that other health care systems around
the world will follow and implement the standards,
so that data can be exchanged
worldwide using the same set of standards.
In the next video, we'll introduce the Azure API for FHIR.
This is the application of
the FHIR specification in the Microsoft Azure Cloud.
Thank you, we'll see you in the next video.
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