Healthcare businesses are increasingly involved in the online exchange of electronic health information. In 2021, 88% of hospitals reported using electronic data exchange compared to 2018 as a means of sending, receiving, storing and analyzing patient data.
With the updated CMS ruling in 2024, it’s clear that strong interoperability EHR will be vital to medical business success.
Navigating the Healthcare Interoperability Landscape: A Guide to CMS Rulings in 2024
The CMS ruling for 2024 presents many changes that healthcare businesses need to navigate in order to successfully reap the benefits of using interoperability in their workplace.
Here are some of the significant interoperability considerations for all healthcare businesses in 2024:
- The reporting period is now 180 consecutive days this year (as opposed to 90).
- There is a new measure called Antimicrobial Use and Resistance Surveillance Measure that you will be required to report on.
- Healthcare providers must attest “yes” to the SAFER guides.
- A reminder that attestation points and eCQM will be publicly reported on Care Compare.
- The eCWM reporting measures bumped up to 6 measures for 4 quarters this year. Three are required, OPI-1 -Safe Use of Opioids, PC-02 – Cesarean Section, PC-07 – Severe Obstetric Complications, with the remaining 3 self-selected.
With these changes in mind, here are the mandatory requirements:
Report measures from the four objectives for 180 consecutive days with a minimum score of 60 points.
- Electronic prescribing
- Health Information Exchange
- Provider to Patient Exchange
- Public Health and Clinical Data Exchange
Attest yes or no to the following 2 measures from the Protect Patient Information objective:
- Security Risk Analysis measure
- Safety Assurance Factors for EHR Resilience (SAFER) Guides measure. Must attest “yes.”
- Complete the actions to limit or restrict the compatibility or interoperability of CEHRT attestation
Additionally, all hospitals and Critical Access Hospitals are required to use CEHRT that has been updated to meet 2015 Cures Edition Update criteria.
Measure Reporting Requirements
There are four categories that must be submitted for participation in the Performance Improvements Program.
You must report certain measures within each category. Points will be awarded for what you submit for these measures.
To satisfy the program requirements, you must reach a minimum score of 60 points.
Understanding Interoperability Regulations
While interoperability is becoming an increasingly relied-upon feature of modern medicine, it relies on different healthcare systems and applications to communicate as a means of sharing data and translating information. Therefore, considering the risks inherent, interoperability is tightly regulated.
CMS has recently issued a series of regulations that will improve this measure for businesses that report. These include:
- Improved Patient Access: CMS mandates that payers provide patients with access to their health information through standardized application programming interfaces (APIs). APIs mean patients can securely access their health data, including claims and clinical information, through mobile apps or web portals.
- Established Provider Directory: Payers are required to maintain and update a comprehensive provider directory, ensuring that patients have access to accurate and up-to-date information about healthcare providers in their network. This directory must be made available through APIs, enabling third-party applications to incorporate this data.
- Standardized Data Exchange: CMS is encouraging the use of FHIR, or the Fast Healthcare Interoperability Resources as a standard for data exchange. If your EHR or business is not yet using FHIR, it would be wise to consider switching to one that does so that you can seamlessly facilitate the sharing of patient data across healthcare applications with security and ease. This will improve care coordination and reduce the administrative burden of standardization.
In addition to the CMS guidelines, healthcare entities need to also be aware of other state-based legal requirements, such as the state of Washington’s My Health My Data Act passed in April of 2023. This is the first privacy law in the U.S. that is not a HIPAA law. This goes into effect for regular entities on March 31st of 2024 and June 30th of 2024 for small businesses, and compliance includes sections 4 to 9.
5 Ways EHR Software is Foundational to Interoperability Success in 2024
It’s clear from the 2024 trends and continuing regulations that EHR and digital health are key components to smooth operations in the U.S. healthcare system; reliable EHR software will also be foundational to interoperability success this year.
An Electronic Medical Records system, or EHR system, supports business and practice management, care components, data exchange, and patient access and to continue to provide those things to a level that meets value-based care, EHR software needs to be held to a certain standard.
As this digital system acts as a centralized repository for patient records, the comprehensive details included in these files, including medical history, treatments, diagnosis, x-ray information, and more need to be secure.
As a critical component of healthcare interoperability, here are 5 EHR considerations.
Choose an EHR Software That Uses Standardized Data, including Industry Accepted Standards like HL7 and FHIR
An EHR software that uses industry-wide standards like Health Level Seven International (HL7) and Fast Healthcare Interoperability Resources (FHIR) will soon be a requirement. The use of these languages, like FHIR, is already on the rise as they create a common means for healthcare data exchange, streamlining interoperability among diverse systems and formats.
Standardization is a core principle of interoperability in 2024 and more will be expected to adopt these standardized codes. This also includes terminologies like SNOMED CT, LOINC, and CPT.
If your current EHR does not contribute to the standardization of health data using these terminologies, then this could be costing your business money through complex data exchange systems and continual roadblocks for sharing information.
Ongoing efforts to establish common standards and facilitate seamless data exchanges will be essential in 2024.
Certified EHR Technology With Specialty Systems Interoperability
While a seemingly basic component to interoperability success, choosing an EHR for interoperability will help you overcome many of the challenges present in EHR systems.
MIPS is now looking for EHR software to be certified and medical entities using a certified EHR or certified electronic health record technology (CEHRT) will be better poised for success in 2024.
Standards and structured data requirements have been set by the CMS and Office of the National Coordinator for Health Information Technology (ONC) and EHRs must meet these standards to qualify for use in the Medicare Promoting Interoperability Program.
While it’s clear that CMS and ONC are making huge steps to improve connectivity, modern platforms need to be designed with interoperability in mind. Using a CERT technology like Picasso by Doc-tor that can connect to other EHR software in varying specialties will ensure that your data exchange adheres to the standardized data formats and communication protocols, enable greater integration with other health information systems, and promote informed decision-making.
Secure Data Sharing and HIPAA Compliance With Cloud Computing Interoperability EHR
Cloud-based EHR software is another core facet of data interoperability that is expected to emerge as a growing and permanent fixture for medical businesses. Cloud interoperability will become a necessary component to support medical business scalability, accessibility, and affordability.
Cloud EHR like Picasso will enable healthcare professionals to securely access patient records from any location with an internet connection, providing easy access to these systems, simplifying data exchange, and improving patient access and care coordination.
Any EHR using cloud computing must take data privacy and security seriously as cloud service poses an additional risk to cybersecurity threats due to the limited control of varying internet connections. Strong security measures will therefore be implemented, such as strict access control and confidentiality measures.
With robust security features, EHR systems use encryption, user authentication, and audit trails to protect patient data. By addressing these security concerns, EHRs help maintain the integrity of interoperability processes.
Patient Portals for Positive Patient Experience and Enhanced Communication and Patient Experience
Much like the portability useful in cloud technology, patient portals are also on the rise in promoting interoperability and value-based care.
More EHRs are expected to provide patient portals that empower patients with the ability to access their health information, schedule appointments, and communicate with healthcare providers. This enhanced patient engagement is likely to improve the overall patient experience and foster more meaningful data exchanges between patients and healthcare professionals.
The introduction of patient portals also introduces concerns over data ownership and control. Striking a balance between the patient’s need to control their health information and the need for a healthcare provider to access patient data is going to require some negotiation.
Improved communication between provider and patient that occurs with patient portals and easy access to their own health data, leads to better treatment outcomes as the patient assumes as more active, and sometimes, proactive role in their care.
Advanced Interoperability Features in EHR
Interoperability features with financial services will also see an increase in 2024. Adopting interoperable systems also means integrated medical billing for streamlined MIPS reporting, HIPAA compliance, and revenue cycle management features.
The use of Artificial Intelligence (AI) capabilities is expected to become more widespread. AI-tools can be used for processing large datasets, detecting patterns in healthcare and diagnostics, and supporting healthcare professionals, improving workflow, diagnostics, and treatment options which, in turn, improve care.
EHRs can be expected to see more integrations with Internet of Things (IoT) technologies like wearable monitors and smart medical equipment. These integrations allow for continuous patient monitoring and provide insights into individual health concerns.
Role of EHR Software in Patient Privacy & Data Storage
EHRs play a critical role in achieving true interoperability and data exchange.
As a centralized repository for patient data, they can streamline access and consolidate information into structured formats, giving authorized users a single, comprehensive source of truth. This means that providers no longer have to sort through paper records or find their way through multiple systems, creating more efficient workflows.
Using cloud technology, EHRs can remove geographical barriers, improving remote or telemedicine services and enabling providers to move between practice locations or patient locations while maintaining access to the necessary records.
EHR systems are expected to explore blockchain-based solutions to enhance data security and integrity. Blockchain technology will contribute to ensuring the trustworthiness of health data, addressing concerns related to data security.
Unleashing the Potential of EHRs for Seamless Data Exchange and Interoperability
EHR software is more important than ever for achieving interoperability and improving patient care.
Interoperability is more than just choosing the right EHR, even though that is a large part of it. It is also considering the different levels of interoperability. Touching on all 4 levels of interoperability, including foundational interoperability, structural interoperability, semantic interoperability, and organizational interoperability is key.
Aside from supporting MIPS reporting requirements and increasing data sharing ease, interoperability:
- Reduces the administrative burdens on physicians
- Improves clinician and patient management of chronic conditions
- Improves efficiency and expedites patient care
While smaller practices may face challenges in implementing and maintaining EHR systems with robust data exchange capabilities, platforms like Picasso, help reduce the gap of economic disparities in the adoption of healthcare IT, creating a more equal access.
Interoperability is essential to the proper function of any healthcare practice. And more than being a desirable element, it is a necessity in 2024 and beyond.
As the first practice management platform designed for the cloud, you can trust Picasso to deliver the capabilities and the security required to keep pace in a rapidly changing healthcare technology landscape.
Contact us today to learn more!