The Health Internet, a Decade in the Making, Gets a Shot in the Arm

By Aneesh Chopra, President and Co-Founder of CareJourney

Earlier today, at the opening ceremonies for the largest health IT conference of the year, Jared Kushner made a surprise appearance committing, unequivocally, to a “whole of government” approach to ensure patients and their caregivers can connect their health data to any application that helps them make better use of it – selecting health plans, choosing providers, or navigating the fragmented delivery system, especially for high-need, high-cost patients. Backed by a series of executive actions, HHS and the VA are doubling-down on work started in the Obama Administration, reinforcing my Innovative State thesis that policies tapping the expertise of the American people to solve problems can be both pro-growth and pro-government.

Here’s a quick primer on today’s executive actions:

1) CMS Administrator Seema Verma launched the “MyHealthEData” initiative and declared her willingness to exercise regulatory and executive authority to compel plans that contract with the agency to enable consumer-directed health exchange, and launched a consumer-focused API preview service of her own, Blue Button 2.0, with a roster of over 100 developers building apps to court 53M eligible Medicare beneficiaries (including our CareJourney team).

2) ONC Dr. Don Rucker expects to issue a series of regulations later this Spring, but once again affirmed his commitment to execute Congress’ will to enable open APIs that can be accessed “without special effort,” including calling for a standards-based approach (“Flat FHIR”) to achieve bulk EHR access for employers, payers or ACOs when contracts allow for it. Our CARIN Alliance team is focused on making a trusted exchange framework work for consumer-directed exchange, including new approaches for incorporating ID proofing into the API infrastructure.

3) VA Secretary David Shulkin introduced “Lighthouse,” a beta API developer portal that portends to offer a “single door” for interop, but perhaps a bit more market changing, he issued a call to action for health systems treating veterans via the Choice Care Act to sign an “Open API Pledge,” including “fast-tracking” FHIR API standards development for resources such as scheduling, clinical notes, and questionnaires that are not yet shipped in production EHR software.

If ONC’s “US Core Data for Interop” represents a regulatory floor for EHR vendors, signatories to the VA’s pledge represent a pioneering group willing to work together to map more of their respective EHR vendor web services to openly available FHIR APIs (and collaborate to lower costs for themselves and others) that meet the spirit of the 21st Century Cures’ “without special effort” clause.

Coupled with Apple Health’s announcement that participating providers must offer FHIR API access constrained by the Argonaut Project implementation guide, and Google Cloud’s Healthcare API offering that ingests legacy standards and transforms data to the FHIR API, it is increasingly clear that Mitch Kapor, Ken Mandl & Zak Kohane’s vision of a “Health Internet” and an “iPhone app store-like” marketplace of substitutable clinical applications, is coming to life nearly a decade since they inspired us.

Our CareJourney team is “all-in” to contribute whatever we can to this movement. Through our growing network of Accountable Care Organizations (“ACOs”), we intend to put this lightweight infrastructure to work, including via a new “Blue Button Developer Analytics Service” allowing our members that incorporate CMS’ API into their mobile or web-enabled apps to deliver insights directly to beneficiaries, including:

  • Reminders to schedule important care events such as annual wellness visits and personalized preventive screenings;
  • Personalized transitional care management visit reminders based on the complexity of the beneficiary’s historical chronic illness;
  • Care coordination strategies based on the beneficiary’s risk stratification and segmentation;
  • Estimates for previous ER or hospital visits that could have been avoided with better outpatient care;
  • The opportunity to share feedback with the beneficiary’s PCP to inform better coordinated care.

There is no doubt we have much more work to do but thanks to the shot in the arm this week by HHS and the VA, we are going to get it done faster for the betterment of the American people.


By | 2018-03-09T14:41:49+00:00 March 6th, 2018|Categories: Blog|

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