Health Data Standards and Terminologies A Tutorial

4: Working Together - Revisiting Organizational Interoperability


Government Programs


Governments across the globe have established programs to encourage and incentivize health system interoperability. In the United States, the following programs are particularly notable in driving interoperability:

HITECH Act

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provided the U.S. Department of Health and Human Services (HHS) with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT. In the beginning of this tutorial, we briefly introduced you to the Office of the National Coordinator for Health Information Technology (ONC, now ASTP/ONC) established by this Act.

Promoting Interoperability Programs

Since 2011, the CMS EHR Incentive Programs (now known as the Promoting Interoperability Programs) have provided financial incentives to providers and healthcare organizations that demonstrate "Meaningful Use" with certified EHR systems.

21st Century Cures Act

The 21st Century Cures Act of 2016 included provisions that advance interoperability, including:

  • A prohibition on preventing or hindering the exchange of health information,
  • Calling on the healthcare industry to adopt standardized application programming interfaces (APIs), and
  • Directing the ONC to develop the Trusted Exchange Framework and Common Agreement (TEFCA) to standardize health information exchange across networks.
MACRA

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 incentivized the adoption of EHR technology and the use of health data standards through advance care information (ACI).

ONC Certification Program

The ONC Certification Program requires the use of EHR technology for participation in federal programs and encourages vendors to develop EHRs that support health data standards such as CDA and FHIR.

CMS Interoperability and Patient Access Final Rule

The CMS Interoperability and Patient Access Final Rule of 2020 requires that Medicare Advantage plans, Medicaid, CHIP, and federal health plans to adopt standardized APIs to enable patient access to their health information.


These programs have collectively driven the adoption of health data standards and interoperability across the U.S. healthcare system, making it easier for providers to share information and for patients to access their health records.