eHealth Exchange

CMS Interoperability Initiative Gains Speed in Race for Patient-Centered Innovation

This article was originally published on LinkedIn by Jay Nakashima, President, eHealth Exchange.

A few months ago, I was honored to represent eHealth Exchange at the launch of the Centers for Medicare & Medicaid Services (CMS) Health Tech Ecosystem initiative. Our organization is proud to have signed the pledge to help empower patients, providers, and payers – as well as the apps they use – with real-time access to secure and complete health information.

We are particularly energized by CMS’ focus on providing patients with access to their health data. As the largest healthcare payer in the nation responsible for 82 million lives, CMS is an ideal advocate for patients, and the eHealth Exchange shares its ambitious vision. In fact, we already support individual access services, meaning we are able to respond to a patient’s data queries from personal health apps that participate in the Trusted Exchange Framework and Common Agreement™ (TEFCA™).

Since the Health Tech Ecosystem launch, we have taken every opportunity to contribute our experience and expertise as part of the working group of early adopters. We are excited to help define the technical specifications and develop the implementation guides it will take to manifest CMS’ vision – including killing the clipboard and enabling conversational AI health assistants.

Passing the baton to patients and their apps

By focusing on connecting health apps and establishing a standard for patient identification, the CMS effectively shifts focus to the patient experience.

In my view, this is an opportune moment for the market to truly embrace individual access. Provider-to-provider exchange in support of treatment is sufficiently mature, thanks to previous federal investment and policy, coupled with significant industry participation. We have the data standards and the networks, and most importantly, strong relationships among industry stakeholders.

Those relationships were established through existing efforts such as Carequality and TEFCA, and the potential for alignment and mutual benefit with the new CMS Interoperability Framework is substantial. By endorsing stronger patient identifiers and driving interoperability to patient and caregiver apps, the CMS initiative will complement the value of these frameworks and regulations to better support the consumer.

Lacing our shoes for the long stretch

As the nation’s oldest and largest health information network, pioneering advancements in health data exchange is core to the eHealth Exchange mission.

We were the first national network to go live with broad, scalable FHIR-based exchange, the first to support exchange for government benefits determinations, and the first to enable electronic case reporting. We were one of the initial Qualified Health Information Networks® (QHINs™) certified under TEFCA. And we’re the only network that connects five federal agencies, enabling data exchange in support of treatment decisions for military service members, veterans, and indigenous residents, as well as drug and vaccine safety reporting and disability benefits claims.

eHealth Exchange has a track record of convening key stakeholders and pushing voluntary initiatives to help our industry get ahead of regulatory requirements. For example, in anticipation of the 2027 compliance deadline for CMS’ Interoperability and Prior Authorization final rule, we launched an award-winning solution to accelerate the adoption of FHIR-based exchange between providers and payers.

This is the spirit – and the experience – we bring to CMS and our fellow early adopters.

Surveying the hurdles ahead

The CMS Health Tech Ecosystem initiative challenges us to acknowledge the areas where innovation is still desperately needed. The work ahead will be demanding.

In pledging to adopt the CMS Interoperability Framework, eHealth Exchange reaffirmed our commitment to serving as a trusted, vendor-agnostic network dedicated to the public good. We are extending that commitment to welcome, with appropriate safeguards as envisioned by the framework, the growing community of personal health app developers.

As we work to unpack the technical requirements to become a CMS-Aligned Network, we’ll be sharing our thoughts on this next leg of the race.

In the meantime, stay hydrated and pace yourselves. Patients are depending on us.

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About eHealth Exchange

eHealth Exchange, a 501(c)3 non-profit dedicated to public good, is the oldest and largest health information network in the country and is most well known as the principal way the federal government exchanges clinical data among federal agencies and with the private sector. Recognized for certified data quality, trusted governance, transparency, and its commitment to privacy, eHealth Exchange facilitates the secure exchange of patient records for more than 300 million patients and processes roughly 25 billion data exchanges annually. Vendor-agnostic, with a broad public health focus, eHealth Exchange provides connectivity for more than 30 electronic health record systems, 58 regional and state HIEs, 75 percent of U.S. hospitals, 90 percent of dialysis centers, 70,000 medical groups, and payers in 34 states – as well as countless urgent care centers, surgery centers, and clinical laboratories. Five federal agencies (Department of Veterans Affairs, Department of Defense, Indian Health Service (IHS), Food and Drug Administration, and Social Security Administration) also participate in the network to share patient information with private-sector partners as well as other federal agencies. Active in all 50 states, eHealth Exchange connects to other national health information networks today via Carequality and now TEFCA™ as a Designated QHIN™. See: https://ehealthexchange.org / @ehealthexchange.

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