Health Agencies Tout Standards in Data Sharing, Interoperability

ORLANDO — As agencies continue to work toward modernizing public health data and setting data standards, Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) discussed the need for interoperability at HIMSS in Orlando, Florida, Wednesday.

Interoperability has been a challenge for health care organizations because of regulations and a lack of standards in the field. Following the COVID-19 pandemic, health care organizations and government agencies began implementing public health data modernization, but smaller and rural health care organizations are lagging behind.

ONC Senior Advisor of the Office of IT Molly Prieto said the best way to speed up modernization is to ensure all organizations have the support they need to make the transitions. Prieto highlighted the partnership between CDC and ONC as the two agencies work together to define the core elements of data needed for public health information.

Fast Healthcare Interoperability Resources (FHIR), a set of standards for exchanging electronic health data, has helped agencies like CMS and CDC. It is used in smartphone technologies, like Apple Health, that allow patients to quickly share information between platforms and providers.

“We’re thinking about how we can use FHIR to light a fire and make sure that we’re getting that information quickly and with limited effort,” Prieto said. “How can we use existing implementation guides and existing FHIR capabilities that might be in place for other use cases [such as] health care to health care or health care to patients?”

CMS is also looking to adapt interoperability and data exchange standards, specifically in long-term and post-acute care (LTPAC) settings. CMS previously created a data element library and officials said the agency is aiming to take a more FHIR-centered approach to allow the sharing of data throughout all stages of a patient’s journey in LTPAC settings.

CMS Acting Deputy Director of the Quality Measurement & Value-Based Incentives Group Traci Archibald explained how reusing data like patient goals from a previous provider can prioritize a patient’s care and outcomes.

“If a patient moves from a nursing home to their home, that nursing home quality data can be used for the quality of reporting program, that the nursing home is responsible for,” Archibald said. “It can also be used for prior authorization to be accepted for home health services.”

As agencies work to improve data sharing and interoperability, they called on industry partners and practitioners to give input on the strategies being put into place, especially as the United States Core Data for Interoperability (USCDI) continues to gain more data elements.

“This is the opportunity for our government and for industry partners to get together and really build upon what was already said in USCDI and to support specific programs and specific use cases,” ONC Interoperability Systems Branch Chief JaWanna Henry said.

Looking Back on 2023 and Ahead to 2024

Since 2019, the CDC has set small, concrete yearly milestones to achieve four overall goals of modernizing public health data: storing core public health data streams, accelerating access to analytics, visualizing and sharing data with the public and working with the ONC. In 2023, the CDC publicly set 15 milestones surrounding the public health data strategy, including things like interoperability and import source data.

Richard Hawes, associate director of technology strategy at CDC’s Office of Public Health Data, Surveillance, and Technology (OPHDST), said the office has reached 12 of its 15 milestones last year and aims to reach 80% of the milestones for 2024.

“If we had hit all 15, it will probably mean that we’re [not being] ambitious enough,” Hawes said. “If we hit five or six, we’ve been too ambitious.”

Hawes highlighted the CDC’s “key achievement” of 2023: a data channel that tracks and provides weekly updates on viral respiratory illnesses like COVID-19, RSV and influenza in the United States. One example of the CDC’s milestones for this year is expanding the number of core data sources, like using wastewater to provide data to the viral respiratory illness channel.

“One of the things is also we’re trying to do is expand our cooperation with ONC and you’ll see a lot of specific milestones about that cooperation,” Hawes said.