EHR Integration What's the Big Deal? January 7, 2023 by Larry Rine Posted on: 15 likes 30 Comments #EHR_Integration #Remote_Patient_Monitoring #FHIR #Healthcare_Strategy #Medical_Devices People have been importing information into Epic and Other EHRs for years. The assertation is correct. Healthcare organizations have managed to import some data into their EHRs for several years. Unfortunately, the process has been expensive, limited, and ineffective. Primarily, those initiatives have been "one-off" scenarios in a limited number of instances. Few have enabled retreival of data from an EHR and none have facilitated seamless interoperability with disparate data sources. Intersect on FHIR has changed that paradigm. Completely. The 21st Century Cures Act Information Blocking Rule, designed to advance interoperability; support the access, exchange, and use of electronic health information (EHI); and address occurrences of information blocking. The legislation mandates that patients or their proxys be able to electronically access and download their medical records. Here is a a quote form the legislative bill: " ....The finalized criterion requires a certified Health IT Module to electronically export all of the EHI, as defined in § 171.102, that can be stored at the time of certification by the product, of which the Health IT Module is a part. We finalized the 2015 Edition Cures Update “EHI export” criterion in § 170.315(b)(10) but did not finalize its inclusion in the 2015 Edition Base Electronic Health Record (EHR) definition, as proposed. Our intention with this criterion, in combination with other criteria set forth in this final rule, is to advance the interoperability of health IT as defined in section 4003 the Cures Act, including the “complete access, exchange, and use of all electronically accessible health information.” The next section of the document continues: "E. Application Programming Interfaces (APIs). We have adopted a new API certification criterion in § 170.315(g)(10) to replace the “application access—data category request” certification criterion (§ 170.315(g)(8)), and added it to the updated 2015 Edition Base EHR definition. This new “standardized API for patient and population services” certification criterion focuses on supporting two types of API-enabled services: (1) Services for which a single patient's data is the focus and (2) services for which multiple patients' data are the focus. The API certification criterion requires the use of the Health Level 7 (HL7®) Fast Healthcare Interoperability Resources (FHIR®) standard Release 4 and references several standards and implementation specifications adopted in § 170.213 and § 170.215 to support standardization and interoperability. This certification criterion will align industry efforts around FHIR Release 4 and advance interoperability of API-enabled “read” services for single and multiple patients."This legislation has basically established the FHIR data-set as the new standard for healthcare data. Following the passage of this legislation, Intersect made the decision to restart development of a remote patient monitoring application which was then being developed with traditional database technology in order to incorporate the newly established FHIR mandate. The recently completed "Intersect on FHIR remote monitoring sytem is the product of that initiative. The neffect of the new FHIR standard has been to create what could easily be referred to as an integrated digital healthcare data platform. The foundation of the new system is cloud data repository hosting the entirity of the FHIR data set. All that is needed to create seamless connectivity with Epic or other Certified EHRs are the same APIs that were developed to create the Intersect on FHIR web application and the mobile application deployed on patient's cellular devices. In that scenario, the data is "just there" and when new data is created from virtual patient encounters or from attached medical devices, those data feeds are appended to the medical record in real-time as they are created. This seamless interoperability means that when providers are conducting a virtual visit or a face-to-face encounter, they have access to the entire patient record without having to search for it. As virtual care-delivery become of greater and greater importance, ready access to the patient's entire record becomes more and more important. In addition to enabling integrated virtual care-delivery, Intersect on FHIR's use-cases as an integrated digital data platform provide other important benefits. An obvious instance of where an integrated patient record is important is the enhanced capability to leverage AI for clinical and administrative predictive analytics and automated processes. Intersect's tight partnership with Genetica.ai can enable those outcomes. Additional instances of where data integration can greatly enhance performance is when consolidated reporting is required, and in the instances when, following a merger or acquisition there is the need for merging data from two or more systems. Savings from time and process requirements can be obtained on an order of magnitude. In summary, the differences between what is possible with data integration between legacy methods and what Intersect offers with FHIR are transformational. It is a big deal.