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Readers Write: Improvements in Content Quality, Regulations Highlight 2021 Interoperability Trends

December 6, 2021 Readers Write 1 Comment

Improvements in Content Quality, Regulations Highlight 2021 Interoperability Trends
By Jay Nakashima

Jay Nakashima, MBA is executive director of EHealth Exchange of Vienna, VA.


Once again, the COVID-19 pandemic grabbed many health IT headlines in 2021. But interoperability was a major topic in 2021 as it truly turned a corner during the last 12 months. More providers are connecting into data sharing networks, and this is good for everyone. This momentum should continue in 2022, but definite challenges will arise.

As someone who heads the oldest and largest nationwide health information network in the United States, I continually monitor trends in healthcare technology. While the past 12 months have been packed with major developments, the following are what I deem are the most significant interoperability trends in 2021.

Public health emphasis. The COVID-19 pandemic spotlights the digital disconnect between healthcare systems and public health agencies. Much work remains in this area, but now it is recognized as a major issue and helped to drive the conversation around health IT this year. The EHealth Exchange partnered with the Association of Public Health Laboratories (APHL) to enable automated generation and transmission of case reports from electronic health records (EHR) to the necessary public health agencies, increasing accuracy while reducing reporting burdens of providers. This electronic case reporting (eCR) service is available to EHealth Exchange network participants, as well as those outside the network but connected via Carequality. The EHealth Exchange – APHL connections can be used for any reportable disease or condition, not just COVID-19.

Regulations. The information blocking rule clearly expanded access to patient data requested for treatment purposes. Anticipation of the final rule alone propelled EHealth Exchange’s transaction volume to 12 billion transactions annually. The industry continues to anticipate and plan for the Office of the National Coordinator for Health Information Technology’s (ONC’s) new Trusted Exchange Framework and Common Agreement (TEFCA) exchange paradigm.

Content quality. The industry as a whole saw great improvements in content quality in 2021. For example, 98% of EHealth Exchange participants were able to successfully pass rigorous content quality testing. Because of the vast number of participants and their influences in healthcare, there is now a new, universal floor of interoperability inside and outside the network. This means that the network isn’t just moving data; it is moving standards-based, computable data, which is human readable and machine consumable, the gold standard for interoperability.

Adoption of new technology such as FHIR. While exchanging Fast Healthcare Interoperability Resources (FHIR) at scale still requires final new standards, particularly related to security, the industry as a whole worked to implement FHIR in production after successful proof of concept initiatives. In partnership with public health, we expect to see finally see the promise of FHIR in broad, real-world connectivity in 2022.

Of course, these are not the only trends that drove the healthcare IT sector in 2021. We saw a major emphasis on privacy, cybersecurity, controlling healthcare costs, and efforts to address disparities. Look for these and other trends to continue into the new year as the sector continues to evolve and address new challenges that will surely appear.

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Currently there is "1 comment" on this Article:

  1. Good reminder that Interoperability regulations would have debuted at HIMSS20 if it had happened in person. Instead it got a little lost in the rush to respond to the public health emergency. It’s inspiring to think about all the health systems that have FHIR in place now even before the ONC regulation required it. As to the content quality, by “content” I take it that you mean data quality. I have another definition of the word “content” that has to do with the health information that helps people understand their health data. A couple of years ago I was thinking that interoperability was going to create a renaissance of consumer facing experiences, richly personalized by the structured data flowing through the open APIs and exchanges like yours. This imagined future would build on the success we had with HL7 InfoButton and retrieving contextually relevant health information to help people understand the data in their EHR’s patient portal/app. I haven’t quite seen the result I was expecting. Maybe the future data driven, digital health, consumer experience will be more immersive than that old patient portal design.

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