Health agencies say interoperability is key to sustainable infrastructure


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Leaders from FDA, ONC and AV discuss how they are improving data flows to strengthen IT infrastructure.

Leaders from the Departments of Health and Human Services (HHS) and Veterans Affairs (VA) are driving data interoperability to improve health outcomes and advance the infrastructure required for sustained success at scale.

“The fragmentation of the health care industry on the supply and demand side is the biggest challenge we all face,” said Micky Tripathi, national health information technology coordinator at ONC at the Digital Medicine Society Virtual Event. “There is certainly the danger of too much regulation which then stifles this innovation.”

Within the federal health sector, Tripathi noted that agencies are seeking to modernize regulatory processes and strengthen interoperability to ensure both speed and safety of vital health services. ONC is piloting standards-based APIs across the market to advance interoperability and provide patients and providers with access to health data and records.

“This is why we support the possibility of having the exchange using APIs as well as networks,” Tripathi said. “Regarding the 21st Century Cures Act, the Trusted Exchange Framework Network that will go live in the first quarter of 2022 supports more of the backend connection, so you also have the option to have background recording sharing with authorized parties. . ”

At VA, Kimberly McManus, Presidential Innovation Fellow at VA’s Office of Information and Technology, said the agency is strengthening data interoperability to successfully collect, analyze and share critical health data . McManus explained that the agency is putting in place a new framework to break down traditional silos to democratize access to data and improve the ability to evolve valuable digital health technologies across the system.

In 2020, the agency launched a new cloud-native enterprise data and analytics platform, called “Rockies,” to ease the burden of accessing, integrating and organizing people. data while enabling a heterogeneous ecosystem for data analysis.

“The platform enables this systematic conservation organization and the integration of various data sources, from electronic health record data to mobile application data, including future sensors and imaging data, which will allow us to to provide better quality care more quickly to veterans, ”added McManus. .

COVID-19 has only accelerated the modernization journeys of agencies. VA has had to develop digital services like telehealth to keep pace with rising demand. In the first few months of the pandemic, VA saw a 1,000% increase in telehealth visits and a 24% increase in secure messages.

“VA continues to strive and modernize this data infrastructure, so that we can truly advance this concept from anywhere to anywhere, which means veterans and healthcare providers can be located anywhere and can communicate effectively through digital tools, ”said McManus.

VA has developed a new suite of digital tools, based on the agency’s modern cloud-based data infrastructure and DevSecOps approaches, to improve information sharing, symptom screening, vaccinations, testing clinics and other applications and services to rapidly provide care and support veterans’ health outcomes. Among these tools, VA launched its COVID Patient Manager, which is a SMART app on FHIR to guide COVID-19 patient care.

“In a healthcare system in 2021, data really serves as the foundation for decision-making and the delivery of care,” said McManus. “A common trend we’ve observed is the need to take data from disparate sources… and combine and merge that data to develop critical information. ”

As healthcare agencies modernize their platforms, the Food and Drug Administration (FDA) is turning to cloud and security to strengthen digital tools and services. Kevin Fu, acting director of medical device cybersecurity at the FDA’s Center for Devices and Radiological Health (CDRH), said the agency recently released a paper on how to communicate computer security vulnerabilities to patients .

“Patients play a very important role in having a voice over the security and privacy of a computer,” said Fu. “There are some wonderful places where you can achieve interoperability and security at the same time, but more often than not it’s competing properties. It is therefore very difficult to have both at the same time.

Tripathi said a fundamental element of security is the user’s understanding of risk. ONC is exploring new education and training programs to provide better knowledge of data sharing risk management.

“We should be really aware of the security and privacy concerns associated with information that goes beyond HIPAA limits,” Tripathi said. “There are a lot of concerns about how we are giving the right education to individuals so that they know what they are getting into and what risks they might be taking. ”

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