The Health Resources and Services Administration is beginning to use HL7's Fast Healthcare Interoperability Resources-based application programming interfaces to streamline reporting processes and enhance data quality. 

Since April 2024, HRSA has received Uniform Data System reports with de-identified patient-level submissions from health centers representing 2.2 million patients in proof-of-concept FHIR exchange testing, HRSA and the Office of the National Coordinator for Healthcare Technology said in a joint announcement on the ONC blog.

WHY IT MATTERS

Personnel at HRSA's Health Center Program perform chart audits, data extracts and aggregation in multiple data formats to accomplish reporting for UDS+ – a core set of measures that evaluate a federally-funded health center's quality of operations and performance.

The program funds nearly 1,400 health centers across the U.S. and provides primary care to the underserved in all 50 states and territories. While the reporting burden has been high on these health centers, HRSA said it needs better data to ensure funding delivers affordable, accessible, high-quality and cost-effective primary healthcare services. 

By working with the UDS Test Cooperative, which consists of more than 124 HRSA-funded organizations, ONC's USCDI+ initiative helped launch one of the first real-world implementations using the Health Level 7 International FHIR Bulk Data Access standard as part of a federal program, according to Steven Posnack, deputy national coordinator for health information technology, and Jim Macrae, associate administrator for primary health care at HRSA.

ONC and HRSA aligned the annual UDS reporting program with FHIR-based APIs available in health IT certified through the ONC Health IT Certification Program by using at-rest APIs – commonly used programming code that allows transmitting data between one software product and another in digital communications, Posnack and Macrae said in ONC's HealthITBuzz blog highlighting the milestone.

The agencies also collaborated to create the UDS+ FHIR Implementation Guide on which the exchanges have been based.

Posnack and Macrae said that ONC and HRSA's partnership represents coordination across the U.S. Health and Human Services to actively support healthcare access in high-need communities.

By aiming to modernize data exchange and test UDS+ FHIR IG requirements, HRSA will have a "fuller picture of health center patients’ needs to best target efforts to improve health outcomes and reduce health disparities, in addition to reducing reporting burdens for health center grantees," they said.

"Looking ahead, UDS+ can be used to support even more quality improvement and innovation across the Health Center Program," Posnack and Macrae added.

"ONC and HRSA's recent announcement that they are using USCDI+ and the Bulk FHIR API to better and more easily analyze data from the wide network of critically important delivery sites HRSA supports is exciting news," Don Rucker, former ONC chief and chief strategy officer at 1UpHealth, told Healthcare IT News on Friday.

"The ability to look at an entire population of patients is critical." 

Rucker also said that he looks forward to extending Bulk FHIR data standards to the Centers for Medicare and Medicaid Services Access APIs – to enable for payer-provider and payer-payer data exchanges – and seeing the "Veterans Administration follow the lead of HRSA."

"The USCDI and Bulk FHIR were designed to provide the digital glue for a learning healthcare system and fully computable accountability for the performance of these providers in a modern big data way." 

THE LARGER TREND

The second version of ONC's Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency and Information rule, HTI-2, is expected to further FHIR exchange by including new certification provisions for APIs.

Micky Tripathi, national coordinator for health IT wrote in March that the update, currently with the White House Office of Management and Budget, will focus on use cases such as electronic prior authorization, patient engagement, care management and care coordination. 

Sean Sullivan, a partner at Alston & Bird, said it could be the end of June or early July before HTI-2 is released in a recent conversation about interoperability in 2024 due to OMB's backlog.

ON THE RECORD

"This milestone is a shining example of HHS agencies working together to align and coordinate health IT-related activities to ensure that federal agencies and their partners operate as efficiently and cohesively as possible," Posnack and Macrae said in the blog.

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.