Interoperability in healthcare: ‘Cures’ for clinical connectivity

What does the Cures Act do?

The Cures Act has broad applicability, and requires the involvement of multiple stakeholders, namely federal agencies, individuals (patients, caregivers, and family members serving in non-professional roles), healthcare providers, public health authorities, insurance companies and payers, technology developers, and health information networks (HINs).

The Cures Act contains provisions to:

• Advance healthcare systems’ interoperability
• Provide patients with access to their health information
• Accelerate research into serious illness
• Address the opioid crisis
• Streamline development and delivery of drugs and medical devices
• Improve mental health services

Its main purpose is to improve collaboration between providers involved in patients’ care teams through the transparent use and exchange of electronically accessible health information. The Cures Act also makes provisions for patients to have access to their personal health information without undue restrictions that could be construed as “information blocking,” whether intentional or inadvertent.

Information blocking is any practice or policy that is likely to interfere with or restrict the authorized access to, or the exchange or use of, electronic health information (EHI).

Refer to this information blocking checklist to assess whether your practice is in compliance.

Key Cures Act dates through 2023:

• Oct. 6, 2022: Definition of EHI no longer limited to EHI identified by data elements in U.S. Core Data for Interoperability (USCDI)
• Dec. 31, 2022: Deadline for New HL7 FHIR API capability, as well as other criteria, to be available
• Dec. 31, 2023: Deadline for New EHI Export capability to be available

Go to a detailed timeline.

What is interoperability in healthcare?

Interoperability solutions in healthcare rely on a variety of components working together. The goal is easy and secure access to a system through which providers can deliver care and exchange information within and across organizations — without compromising patient privacy.

Such solutions should enable integration and the cooperative use of relevant patient health information across a wide range of devices, systems, and applications without any special effort on the part of the end users: the providers, patients, or health information network administrators that require access to this information.

These days, as practices use EHRs to capture patient information, many face significant cost burdens in their attempts to interface and share pertinent patient information with other organizations.

Similarly, many local and regional HINs in operation throughout the country — often due to limits in contractual agreements or competitive interests — have difficulty sharing information. The Cures Act aims to address this scenario, which continues to be an inconvenience for patients and caregivers.

The Cures Act proposes the development of a Trusted Exchange Framework that would harmonize individual interfaces while improving provider efficiency and maximizing health IT developer resources. An integrated exchange framework would lead to greater benefits of interoperability in healthcare — it would allow authorized users ease of access to information useful for all stakeholders involved.

What are the implications for HINs and payer organizations?

Greater insight into patient data would allow for better data analysis to enhance care coordination. Understanding population data such as patients’ social determinants of health — including food security status, housing stability, and access to reliable transportation — can enable better risk analysis for more informed treatment decisions. Such an understanding can help address health risks within certain patient populations.

• For providers: Having access to a centralized pool of information, including data previously documented by other providers in a patient’s care team, would lead to safer, more effective patient care. With access to previous clinical documentation such as lab results, providers could eliminate duplicate testing and ensure adherence to care management protocols. Thus, providers could make more informed clinical decisions and conduct appropriate follow-up as needed, while reducing or eliminating double documentation.
• For patients: Having access to personal health information from across the care continuum, regardless of provider type, could increase patient satisfaction. The same is true for those authorized to view information on patients’ behalf. Having access to a secure patient portal, and being able to send and receive secure messages, could help patients make health decisions.

Benefits of interoperability in healthcare

Standardizing care and access to information, irrespective of the patient care setting, stands to improve patient outcomes and simplify provider workflows. By implementing systems that promote interoperability, within and across systems and organizations, practices avoid information blocking and encourage patient-provider interactions. These interactions empower patients to take an active role in the management of their medical care.

Similarly, when providers gain a more comprehensive view of patients’ medical histories and needs, they too are better equipped to make more informed clinical decisions. Another benefit of interoperability in healthcare that sometimes gets overlooked is that when providers experience simplified workflows with fewer administrative duties, they can focus on delivering quality patient care rather than troubleshooting their health IT solutions.

On the path to value, an important step

In the end, the Cures Act is an important step toward transitioning to a value-based healthcare system — a more patient-centered approach to providing medical care. Practices that implement interoperability solutions will be poised to experience greater competitive advantage with patients, as well as with providers they may attract.