Certification/MU tweaks to support patient subscriptions

This is a quick description of the minimum requirements to turn patient-mediated “transmit” into a usable system for feeding clinical data to a patient’s preferred endpoints. In my blog post last month, I described a small, incremental “trust tweak” asking ONC and CMS to converge on the Blue Button Patient Trust Bundle, so that any patient anywhere has the capability to send data to any app in the bundle.

This proposal builds on that initial tweak. I should be clear that the ideas here aren’t novel: they borrow very clearly from the Blue Button+ Direct implementation guide (which is not part of certification or MU — but aspects of it ought to be).

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Improving patient access: small steps and patch-ups

In a blog post earlier this month, I advocated for ONC and CMS to adopt a grand scheme to improve patient data access through the SMART on FHIR API. Here, I’ll advocate for a very small scheme that ignores some of the big issues, but aims to patch up one of the most broken aspects of today’s system.

The problem: patient-facing “transmit” is broken

Not to mince words: ONC’s certification program and CMS’s attestation program are out of sync on patient access. As a result, patient portals don’t offer reliable “transmit” capabilities.

2014-certified EHR systems must demonstrate support for portal-based Direct message transmission, but providers don’t need to make these capabilities available for patients in real life. Today, two loopholes prevent patient access:
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HIMSS14: Health IT’s Next Boom Cycle

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InformationWeek Healthcare, February 25, 2014 — Mark Braunstein
We’ve seen health informatics booms and busts before — will this one be different?
I’ve been attending HIMSS for decades, and in my view, the exhibit hall is the place to get a true pulse of the industry and the field in general. Over the years we’ve seen booms and busts. I remember HIMSS in my hometown of Atlanta during the heyday of health information exchange in the 90s, when the regional phone companies (remember them?) had huge exhibits touting their entry into the health informatics space…

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Top Ten Tech Trends: Catching FHIR

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Healthcare Informatics, February 19, 2014 — David Raths
A New HL7 Draft Standard May Boost Web Services Development
Standards development work in healthcare is a challenging, often thankless task, and definitely more of a marathon than a sprint. It isn’t often that a proposed standard garners genuine enthusiasm among people working on interoperability issues, but that is what is happening with HL7 Fast Healthcare Interoperability Resources (FHIR)…

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