The Pew Charitable Trusts along with Microsoft, the American Medical Informatics Association (AMIA) and the Commonwealth Fund are throwing their weight behind the Office of the National Coordinator for Health IT's (ONC's) information blocking proposal.
These groups and a handful of others wrote this week to the chairs and ranking members of the congressional committee overseeing health IT urging them to support efforts by ONC to boost the use of application programming interfaces (APIs) to enable more seamless transfer of patients’ electronic health data.
Their support stands in sharp contrast to some organizations criticizing the proposed rules—which define exceptions to the ban on information blocking—for being too burdensome and costly. The Health Innovation Alliance, formerly Health IT Now, even called for the rules from ONC to be scrapped entirely and rewritten.
Congress mandated the use of APIs to improve healthcare interoperability in the 21st Century Cures Act. ONC's draft information blocking rule aims to implement those provisions, including by requiring use of the Fast Healthcare Interoperability Resources (FHIR) standard, identifying guides to use when implementing FHIR and increasing the data that can be made available via APIs.
Back in May, Senate Health, Education, Labor and Pensions Committee Chairman Sen. Lamar Alexander, R-Tennessee, called on Department of Health and Human Services officials to consider delaying the implementation of the ONC rule along with the Centers for Medicare & Medicaid Services' interoperability rule.
The lawmaker also suggested taking a more phased-in approach, voicing concerns about the burden on providers and vendors as well as data privacy risks.
In the letter to Alexander, ranking member Patty Murray, D-Washington, House Energy and Commerce Committee Chairman Frank Pallone, D-New Jersey, and ranking member Greg Walden, R-Oregon, the healthcare groups said APIs are the foundation to the modern internet and ONC's proposal requiring the use of FHIR-based APIs will help standardize healthcare data exchange, the groups said.
"ONC’s proposed regulations take important steps to meet [the 21st Century Cures Act] goal by relying on standards-based APIs that can enable the health care system to leverage the same internet-based tools that fuel innovation in other industries. We urge you to support ONC’s approach that can improve the coordination, quality, and safety of care," the organizations wrote.
Use of the FHIR API standard would also prevent individual technology developers from implementing proprietary APIs that make it more difficult to exchange data, the groups said, also suggesting that ONC should adopt the most recent version of the standard—called Release 4.
AMIA, the Pew Charitable Trusts and other cosigners also applaud ONC's proposal that requires the use of guides providing some constraints on how to implement FHIR. This will better ensure different systems can communicate standardized data, the groups wrote.
The groups also suggest ONC explore additional capabilities APIs should have via subsequent rulemaking. As FHIR further develops and API adoption increases, ONC should explore the use of write capabilities, or the ability to add information to a patient's record, for the bidirectional exchange of information out of and into EHRs by third-party applications.
Other cosigners of the letter include the American Academy of Family Physicians, American Academy of Neurology, American Health Information Management Association, CARIN Alliance and SMART Health IT/Boston Children's Hospital.