The Office of the National Coordinator for Health IT should expand data available to patients and providers via APIs, going beyond common clinical data sets, Pew Charitable Trusts Manager of Health Information Technology Ben Moscovitch told ONC Chief Donald Rucker, MD, in a letter.

To Moscovitch, while CCDs contain key information on patient medical histories like allergies and medication, they omit essential data relevant to care.

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Under the 21st Century Cures Act, the ONC is required to support API development to help health systems share more patient data with other networks. However, it fails to explain what information should be included.

Pew asked ONC to define what “all data elements” means for APIs to expand the included type of medically relevant information. The ONC recognized these limitations in its draft Trusted Exchange Framework and Common Agreement released last week.

Further, while data in EHRs might not be structured in a standard form, Moscovitch said that this shouldn’t limit access. Items like free text notes may not be essential, but non-standardized data could be useful to patients when displayed in PDF or text form and could be accessible through APIs.

Expanded API functionality will let patients easily gain more information from their health records and also foster “interoperability among facilities and development of new clinical decision tools for care providers,” the letter said.

When defining all data elements, Pew said ONC should consider adding medical imaging, allergy data and family medical history, which have fairly widely adopted standards. Social determinants should also be included, although the standards are mature and haven’t yet been widely adopted, Pew added.

And even though standards aren’t fully developed, Pew told ONC to consider adding genomic, patient-generated and medical device data.

The ONC should also consider using FHIR as the “technological backbone to API functionality” through regulations, which will give developers better direction in API development, Pew said. And the agency should ensure that EHR data in structured and standardized formats remain in that format in the API.

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com