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What payers and providers need to know about the ONC and CMS information blocking rules

April 12, 2021
Business Affairs Insurance

The pandemic has exacerbated these challenges for payers and providers – demanding ever-increasing rates of data sharing/reporting and technology implementation. Had the new rules been in place prior to the pandemic, the industry may have faced fewer challenges around contact tracing, managing testing, tracking PPE and other vital medical supplies, accessing data from alternative care settings and more.

One requirement of the new rules is the implementation of FHIR APIs, which will help to address data quality problems, inconsistent data, disparate data formats and missing information – all of which are critical to making informed care decisions and accurately processing claims.

Though FHIR is a powerful new tool for improving interoperability, there are still complications that need to be addressed. Variations in data formats for solutions that have implemented FHIR, as well as use cases where FHIR is not the best solution, are just two quick examples.

However, with the right integration technology such as integration engines and API managers, payers and providers can resolve many of their long-standing interoperability challenges, while also complying with industry regulations (i.e., implementing FHIR APIs), and minimizing the strain of the pandemic on core systems and personnel.

Integration engines and API managers are capable of coalescing with a range of systems and technology across the healthcare ecosystem, acting as a protective barrier between vulnerable health data and any threats of compromise. These tools offer a central hub to which all other systems and technology connect, thus limiting the number of point-to-point integrations.

These tools also inherently understand FHIR data and APIs, allowing payers, providers and patients to access data as it suits them, the very same way they would if they were using a database. Additionally, integration engines have the ability to seamlessly convert FHIR resources into an HL7v2 message, allowing third party systems optimized for HL7v2 to integrate seamlessly using the latest FHIR standards.

Why interoperability matters in meeting the pandemic’s demands
Though many IT teams and infrastructures have not been optimally prepared for these challenges, by prioritizing interoperability technology, they can address the need for high-performance data sharing at scale, and benefit from the flexibility to incorporate data from a wide range of sources, formats and protocols.

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