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Outlining CMS, ONC Next Steps to Advance Health Data Interoperability

The two agencies are working together on USCDI+, electronic prior authorization improvements and more.

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The Centers for Medicare and Medicaid Services is working alongside the Office of the National Coordinator for Health IT to leverage better interoperability and IT capabilities.

The two agencies have been taking steps the past couple of years to increase interoperability and increase patient access to health data, such the Interoperability and Patient Access Final Rule, U.S. Core Data for Interoperability standards, information-blocking rule, FHIR application program interface standardization and more.

While CMS and ONC are helming different aspects of these grander steps for health data interoperability, CMS Deputy Chief Health Informatics Officer and Health and Human Services Senior Policy Advisor Alex Baker highlighted at the HIMSS conference Thursday some newer strides that ONC and CMS are taking together to meet these goals.

One of these strides is found in USCDI+, a service for ONC’s federal partners like CMS who have specific needs to establish, harmonize and advance the use of interoperable datasets that extend beyond USCDI. Baker said that USCDI+ will help agencies like CMS meet their agency-specific programmatic requirements. For CMS, this is especially useful for quality measurements.

“One of the initial things that we’re focusing on under this initiative is work with CMS around quality measurement and understanding what other data may be needed for quality measurement,” Baker said.

ONC and CMS are also working together to improve electronic prior authorization and reduce burden that respectively comes with current prior authorization processes. ONC’s Health IT Advisory Committee released a request for information Jan. 24 to aid CMS with this effort, with the aim to address questions about what electronic prior authorization capabilities should be addressed in the ONC Health IT Certification Program and what implementation specifications ONC should consider in its certification program to support prior authorization.

“We looked at some of the current standards that are available in the marketplace that are emerging or that folks may want to consider for inclusion in the certification program,” Baker added. “We also focused in on the specific issue of health care attachments, which of course has been a long-time discussion across HHS. … And then finally we talked about impact that these changes might have on stakeholders.”

Comments for ONC’s electronic prior authorization RFI are due March 25.

Moving forward, Alexandra Mugge, CMS Deputy Chief Health Informatics Officer, said that CMS is focused on further collaborative efforts with ONC. These include improvements in public health systems. Mugge said that CMS recently finalized the electronic case reporting measure and uses ONC’s certified health IT capabilities to support it, for instance, and CMS is working to improve public health data exchange as well — an effort that CDC and ONC have also committed to.

Mugge added that CMS and ONC are also aiming to improve the accuracy of provider directories and include more digital information to support better electronic data availability and stream.

“We’re really stepping up those efforts to make directories more of a focus and a key connection point for data exchange and interoperability,” Mugge added. “You can’t exchange data if you don’t know where to find another provider to send that data to or find that payer that you need to send data to. How can we better support that and make them a reality?”

CMS is also looking to support building out the Trusted Exchange Framework and Common Agreement (TEFCA) that ONC stood up in January. Mugge said that CMS and ONC are working together to figure out how the national network of health information exchanges can support CMS’s mission.

Finally, Mugge emphasized that CMS and ONC are prioritizing collaboration around improvements in quality measurements.

“CMS and ONC are collaborating on advancing digital quality measurement by leveraging innovation around FHIR-based API and the USCDI+ initiative,” Mugge said. “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 burden on providers, but also help us collect data that can enable us to do more analytics and identify ways to improve care.”

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