Stakeholders Ask Congress to Support ONC’s Vision for APIs

Sept. 16, 2019
A collection of organizations is asking members of Congress to support ONC’s proposed rule on interoperability and patient data access

A group of healthcare stakeholders has written to congressional committee members, urging them to support recent efforts by the Office of the National Coordinator for Health IT (ONC) to boost the use of application programming interfaces (APIs) to extract and use patients’ electronic health data.

Via a proposed rule released earlier this year by the Department of Health and Human Services (HHS) on interoperability and patient data access, federal health IT officials are aiming to require 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.

Now, multiple industry stakeholders, including the American Health Information Management Association (AHIMA), The Pew Charitable Trusts, Microsoft, and others, have written to members of two congressional healthcare committees, asking them to “support the approach ONC takes in their proposed regulations to help ensure that patients, providers and clinicians have more complete health information wherever and whenever they need it.”

The organizations noted that in the 21st Century Cures Act, Congress required ONC to develop new criteria for EHRs to make patients’ medical information available via APIs—software tools that allow systems to request and deliver information to one another. “APIs are the foundation to the modern internet; they allow travel websites to aggregate fares from different airlines and personal financial applications to pull data from an individual’s accounts, among countless other everyday uses. Cures’ directive to integrate APIs into EHRs will bring that same seamless information exchange into health care, granting patients access to their data, improving communication between providers, and giving clinicians additional decision support tools to enhance their ability to offer quality care,” they wrote.

In its rule, ONC has proposed to require the use of the FHIR standard, which many believe will make it far easier for systems to request specific patient information. “Use of the standard would also prevent individual technology developers from implementing proprietary APIs that make it more difficult to exchange data. In finalizing the proposed rule, ONC should maintain its commitment to FHIR-based APIs,” the organizations wrote.

What’s more, they noted that ONC should finalize its proposal that will require the use of a clear implementation guide that will aim to provide constraints on how to implement FHIR, which will better ensure that different systems can communicate standardized data, the groups believe.

They also want ONC to finalize its proposal that will expand the EHR data that can be made available via APIs to eventually meet the statutory requirement of making “all data elements” accessible. “These additional data elements can improve the quality, safety, and coordination of care,” they wrote.

The organizations further stated that the final rule should address future API needs, such as EHRs enabling “write access,” which is the ability to add information to a patient’s record, rather than just being able to read—or view—it.

This summer, other organizations expressed major concerns with the government’s proposals, particularly as it relates to their vagueness, as well as timelines that some feel are far too aggressive.

Nonetheless, these organizations concluded, in their letter, “Under the leadership of your Committees, Congress set a vision for nationwide interoperability so that patients could more easily get their data, clinicians could extract information from EHRs, and different systems could more readily communicate with each other. ONC’s proposed regulations take important steps to meet that 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.”

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