Last time you were here, we talked about the HITECH Act. The time before that, we took a quick dive into an overview on federal policy. Today, we’re going to pick it up from where we last left off on Meaningful Use. Here’s a pretty great summary of the evolution of Health Tech interoperability.
Welcome back, Health Tech Policy friends!
Last time you were here, we talked about the HITECH Act. The time before that, we took a quick dive into an overview on federal policy. Today, we’re going to pick it up from where we last left off on Meaningful Use.
Let’s revisit this for a minute: the HITECH Act established the Meaningful Use program. Meaningful Use was defined by the use of certified (by an ONC-approved certification body) EHR technology in a “meaningful” manner (for example electronic prescribing) thus ensuring that technology used improves the quality of care. It seemed pretty great, but there were a few problems, like a lack of standardization, inconsistent data quality, onerous enforcement and incompatible system design. It was eventually rebranded to Promoting Interoperability Programs and set the stage for the beginning of a discussion and set of requirements around the use of APIs.
In 2014, HIMSS decided to take some interoperability definitions used in other industries and detailed three levels of interoperability required to improve the efficacy of health data exchange architectures, application interfaces and standards. These were later updated in March 2019 to include a fourth level. We think this is a pretty great summary of the evolution of Health Tech interoperability:
The Four Levels of Interoperability
We made you a pretty diagram too:
So what came next, Alie?
The 21st Century Cures Act (Cures Act) was signed into law on December 13, 2016 by President Obama. It was an almost completely bipartisan law, passing the house 392-26 and the senate 94-5. It very nicely, with the HITECH Act signed in 2009, bookended President Obama’s presidency with laws that involved access to healthcare data. The law, and the associated policies that have been recently implemented were designed to:
For our purposes, it also very importantly includes provisions that push for greater interoperability, adoption of electronic health records (EHRs) and support for human services programs. Here are some of those key relevant provisions:
There’s another piece of the puzzle I want to cover: the Trusted Exchange Framework Common Agreement (TEFCA). It’s a common set of principles, terms and conditions for the nationwide exchange of electronic health information. We can further break it down into two parts:
And let’s drill down even further.
The Principles of the Trust Exchange Framework are:
And the Common Agreement includes:
Ultimately, the TEFCA is designed to scale EHI exchange nationwide and ensure that stakeholders have secure access to electronic health information when and where it’s needed.
I’ll have to stop myself here or else I’ll keep going all night. Next time you tune in, we’ll be talking about the players in the interoperability ecosystem.