Delivery of healthcare transformed in the pandemic (SMART on FHIR and the 21st Cures Act). What can patients, providers, payers, and insurance companies gain?
The delivery of healthcare services has gone through an unprecedented transformation during the COVID-19 pandemic. COVID-19 has accelerated the move to a digital-forward model and elevated trends that were previously slow to be adopted. In addition, the final rule of the 21st Century Cures Act, effective June 30, 2020, implements provisions to “advance interoperability and support the access, exchange, and use of electronic health information”.
Technology leaders in the healthcare industry will drive positive business outcomes by continuing to innovate in ways that meet the demands of consumers while also meeting security compliance requirements. Healthcare companies have an opportunity to leverage the current momentum to capture more market share by providing cutting-edge, secure experiences for patients, providers, payers, and insurance companies.
Consumer Demands
Consumer habits have permanently changed across industries over the past 18 months. Healthcare companies providing the best digital experiences will be the ones to attract consumers. In healthcare, consumers include the patients themselves, but could also be caregivers, parents, or patient representatives. Consumers are also the medical staff providing care. A digital experience that makes it easy to share data, retrieve lab results, check coverage, pay bills, etc. will make a big difference to all of these kinds of consumers. It’s likely that in healthcare, consumers will follow the best user experience, as they have in other industries.
A survey of healthcare consumers found that 51% said convenience and access to care are the most important factors in their decision-making. Convenience ranked above insurance coverage (46%), doctor/nurse conduct (44%), brand reputation (40%), and quality of care (35%). Healthcare companies that continue to require patients and providers to use antiquated and disconnected methods to share information with hospitals, specialists, and insurance companies will become less compelling, leading consumers to choose something else. The same applies to providers that stop offering telehealth options for patients. Although the personal experience of an in-person visit cannot be replicated via Zoom, most consumers and providers enjoy having the option when needed.
The intersection of factors such as COVID-19 driving the rise in telehealth services, consumer demand for improved digital access to healthcare data, and recent regulatory mandates creates a shifting technology landscape in healthcare.
Enabling Patient Control over Data: Interoperability with SMART on FHIR
SMART on FHIR is an API that facilitates the exchange of healthcare data. It is part of the 21st Century Cures Act certification requirements. SMART on FHIR is built on open standards including HL7’s FHIR, OAuth2, and OpenID Connect. Developers have the ability to write apps that will run anywhere in the healthcare system. The SMART on FHIR Patient Access API and Provider Directory API came into force on July 1, 2021. The Payer-to-Payer Data Exchange is applicable from January 1, 2022.
SMART on FHIR creates the potential for interoperability and will enable patients, providers, payers, and any other healthcare-related organizations to securely share information, giving patients control over their healthcare data. Patients will no longer have to request records and wait to have them mailed or picked up. Patient control over how and when information is shared will lead to a smoother experience for all parties.
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