On July 1, 2021, new requirements from the US Centers for Medicare and Medicaid Services (CMS) begin that require regulated payers to enable new Patient Access and Provider Directory APIs. While this change may be happening without a lot of fanfare in the news, it’s a big milestone in healthcare. Why? Because it’s one of the first major milestones under the CMS Interoperability and Patient Access final rule | Guidance Portal that impacts health data interoperability for patients.
As CMS continues to build on its roadmap to improve interoperability and health information access for patients, providers, and payers, Microsoft continues to support our partners working with health data. I’m excited to announce that the Azure API for FHIR has new features that make it easier to organize data from across your organization and support the new CMS requirements, including:
- Basic rest capabilities, including create, update, read, patch*, and search.
- Total flexibility over what you can search in the system.
- Leverage industry profiles or bring in your own profiles to further define how data is stored and validate the data to verify it conforms to this context.
- Supports various HL7® Fast Healthcare Interoperability Resources® (FHIR®) operations* called out in the CMS implementation guides. This includes the $member-match operation to assist in data sharing between payers and the Patient/$everything* operation to get all data related to a patient.
What do health organizations need to be aware of on July 1, 2021?
New accessibility for patients: All CMS-regulated payers must utilize FHIR APIs to enable patients with easy access to their clinical information, including claims data. The rule also mandates the use of FHIR APIs to share a provider directory, helping patients find providers for their specific needs or for clinicians to find other providers for care coordination.
New obligations for providers and payers to make data available: With the Patient Access and Provider Directory APIs in place, patients can give their consent to enable data access through third-party applications, ushering in a potentially new landscape of tools and technology that health organizations will have to navigate. The good news? When you’ve enabled FHIR technology for data exchange across your organization, you’ve enabled a robust, extensible data model with standardized semantics that allows all systems using FHIR to work together. Transforming your data to FHIR allows you to quickly connect existing data sources such as electronic health record systems or research databases. And with the new features in the Azure API for FHIR, you can easily support new requests for data access under the CMS guidelines in mobile and web applications.
MultiCare Connected Care (MCC), a wholly-owned subsidiary of MultiCare Health System, is an independent Accountable Care Organization made up of a wide range of health care providers and services. MCC implemented, in partnership with a payer partner, a pilot use case for Medication Reconciliation using one of the Da Vinci Implementation—Data Exchange for Quality Measures. This was a customized solution to see if the standards can deliver on reducing provider and patient burden by changing how MCC collected and delivered compliance quality data to their payer partners. MCC achieved a 40% improvement in their compliance by reaching data parity.
The challenge was now “how to scale” this solution which was aiming to finally deliver the right data at the right time and modality to their patients and care providers. This is where Microsoft partnered with MCC to help bring the scale and efficiencies of the API for FHIR to this project.
"At MultiCare Connected Care, our mission is partnering for healing and a healthy future. We live our mission every day, and implementing innovative solutions, helps us deliver on the promise of our mission. MultiCare is utilizing the Azure platform to scale our pilot project to multiple partners. We continue to put our patients first, and new technology is just one of the ways we serve our patients and communities.”—Anna Taylor, Director of Operations at MultiCare Connected Care
For all our customers like MCC, Microsoft is proud to be your preferred partner in health and life sciences. As you make technological decisions and choices in the cloud, we build technology for the unique needs of health data and enable products that are future-ready, so your organization can meet the changing demands of health interoperability.
Microsoft: Your partner for health data interoperability
Microsoft wants to enable our partners to meet the July 1, 2021 requirements and those coming in the next several years from CMS and the Office for the National Coordinator for Health Information Technology (ONC). We’re committed to supporting our partners in the journey of health interoperability in the cloud to improve health data access and patient care.
We are moving to a future where open standards, quick and easy exchange of health data, and end patients having autonomy over their health records will be a reality. The faster we get our data systems and infrastructure in place for this, the easier it will be for organizations and their patients to go beyond just meeting new regulatory requirements and to reap the true rewards of interoperable health data.
Learn more about the Azure API for FHIR’s ability to help you meet the CMS guidelines and about the Azure API for FHIR.
This post was updated on 6/8/2021 to include a revised quote from Anna Taylor.
* Some items are available now while others will roll out between now and the July 1, 2021 deadline.
® Health Level Seven, HL7, FHIR, and CDA are registered trademarks of Health Level Seven International, registered in the U.S. Trademark Office and are used with their permission.