How ONC and CMS are Working Together to Advance Health IT Interoperability

Both organizations are pursuing different aspects of interoperability making strides with policies and initiatives such as U.S. Core Data for Interoperability (USCDI) standards, the interoperability and patient access final rule, the information-blocking rule, and FHIR API standardization.

Last week at the HIMSS conference, CMS Deputy Chief Health Informatics Officer, Alexandra Mugge, and HHS Senior Policy Advisor, Alex Baker, outlined steps CMS and ONC are taking together to better leverage IT and further interoperability goals.

The first initiative, USCDI+, allows ONC federal partners to create, harmonize and promote the use of interoperable datasets that extend beyond USCDI. CMS finds this capability very useful for quality measures and identifying other data needed to measure quality.   

Mugge stated,”Our digital quality measurements have evolved into measures that originate from sources of health information that can be captured and transmitted electronically, and we truly believe that digitizing these measures and getting the data … and USCDI+ — they really help us not only reduce the burden on providers but also help us collect data that can enable us to do more analytics and identify ways to improve care.”

Another initiative focuses on improving the CMS prior authorization process.  ONC is assisting CMS by attempting to determine what electronic prior authorization capabilities should be included in the ONC Health IT Certification Program. ONC’s Health IT Advisory Committee released an RFI for this effort on January 24th. Comments are due March 25th.

Further collaboration efforts between CMS and ONC include plans to improve public health systems and provider directories, and expansion of the Trusted Exchange Framework and Common Agreement (TEFCA).

For example, CMS uses ONC’s certified health IT capabilities to support its finalized electronic case reporting measure, which improves public health reporting. CMS is also working to improve public health data exchange.

CMS provider directory enhancements aim to support better electronic data exchange by including more digital information regarding data availability and exchange capabilities among providers.

Many of the Cures Act interoperability requirements take effect on December 31, 2022. Under ONC’s final rules, applicable certified health IT products are required to provide certain new functionalities to their customers by December 31, 2022. New functionalities include encrypted authentication credentials, multi-factor authentication, audit reports, electronic case reporting to public health agencies, third-party transmissions, and standardized APIs for patient and population services, among others.

According to ONC statistics, health IT developers are making progress toward meeting these requirements, but are far from the finish line.  The two new functionalities with the current highest implementation, encrypted authentication credentials and multi-factor authentication, are only available within 50% of the applicable health IT products.