The Cures Act Final Rule’s technical requirements call for radical changes in electronic Patient Health Information Exchange (ePHI). Care providers must adhere to the CoP requirements for patient event notifications (ADT Notifications) and the real-time exchange of ePHI through APIs in 2021.
In addition, payer organizations must facilitate the electronic exchange of ePHI between other payers and healthcare providers through a patient access API. They must also provide patients with a list of care providers to choose from for medical services by compiling the provider directory API.
These technical requirements are driven by the CMS’s pursuit of seamless semantic interoperability of healthcare systems and the ONC’s specifications for 2015 requirements of Certified Electronic Health Record Technology. While they affect care providers and payers, health IT developers (HIT vendors) are the catalyst to facilitate the patient centric care.
HIT vendors must swing into action to adhere to their regulatory requirements and enable providers and payers to do so in the process. The stifling competition that is already upon them only lifts the normal for innovation and reflex time. HIT software development requires specialized skill sets and exhaustive processes that escalate costs. In a bid to rein in these costs and adhere to regulatory requirements, HIT developers tend to dilute their competitive edge.
Solace Is Near
Being in the crosshairs of regulatory compliance constantly tends to wear down HIT developers. Existing challenges in healthcare interoperability, automation, preventive care and patient engagement (to name a few) require a focus on value beyond software engineering. To scale their engineering efforts, HIT developers must seek assistance from other competent healthcare technology developers in the form of healthcare interoperability services to establish a synergy that will enable controlling costs, achieving more in terms of proofs of concept, and exploring innovation.
Experience with healthcare standards across the healthcare IT ecosystem will enable HIT developers to explore the twilight zone of possibilities through competent health IT services. The following are some essential services for all the parties affected by the Cures Act Final Rule mandate (providers, payers and HIT developers) to consider.
Clinical Solutions: Help resolve all complexities related to EHR systems, Care Coordination systems, EDIS, RIS, Erx solutions and more. It gives HIT developers a chance to revisit innovation.
Financial Solutions: Enable providers and payers to manage reimbursement dynamics across various healthcare settings and health plans. Financial solutions offer HIT vendors an opportunity to master RCM software and claims management solutions at lower capital expenditure.
Interoperability Solutions: HIT vendors can vastly benefit from third-party healthcare IT services providers who specialize in HL7V2/3, EDI, FHIR, IHE, CCDA, DIRECT, DICOM, NCPDP, etc.
Consumer Apps: Delightful mobile apps and patient portals rule the roost in refining the patient experience. Healthcare IT service providers can boost HIT vendors’ efforts and transform patient and member engagement.
Regulatory Compliance: Mainstream HIT developers are already bogged down by the weight of regulatory compliance requirements. Assistance with the technical implementation of the Cures Act Final Rule would vastly improve go to market time for HIT developers.