CMS Head: We're Working Toward Interoperability. Are You?

Healthcare is stuck in a 1990s time warp. That’s according to Seema Verma, M.P.H., who heads the Centers for Medicare & Medicaid Services (CMS).

Of course, much of medicine has made tremendous advances in recent years, resulting in treatments to prevent blindness, virtual training of physicians and more. But in spite of these steps forward, healthcare organizations still depend on faxes, CD-ROMs and paper notes. Interoperability remains elusive, and patients still don’t have access to, never mind ownership of, their medical data, which are bound to a single provider.

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“What we have today is a technological Tower of Babel, where systems speak different languages, information is not communicated, records are not interoperable, and patients and providers don’t have access to the information they need to make the best decisions,” Verma told healthcare leaders and health IT developers this afternoon at the ONC Interoperability Forum in Washington, D.C.

In recent days and months, CMS has unveiled a flurry of new initiatives and rules, some finalized and others proposed, that are designed to strengthen interoperability. The MyHealthEData initiative, the Promoting Interoperability Rule and similar undertakings are expected to ease provider documentation requirements, combating burnout, and open up patient data sharing. The agency has even set out to hire its first chief health informatics officer, who will be charged with leading health-tech innovation.

The largest payer in the country, CMS serves 130 million United States beneficiaries. Although Verma said that number alone makes any interoperability work performed within CMS important, it’s not enough. At the forum, she pushed for payers and all other healthcare stakeholders to follow her organization’s lead.

“It’s time for the rest of the industry to do its part,” she said. “We are thinking about ways to encourage the market through innovation and investment to advance digital health and encourage new companies and entrepreneurs to use data that we can make available that will help change the expectations of the healthcare delivery system.”

Verma has already asked payers to provide claims data to patients, and her team is exploring how new payment structures could incentivize interoperability. CMS also intends to craft policies that encourage the secure exchange of medical data among providers, patients and insurers on a daily basis.

And the agency isn’t simply hoping private groups will do the legwork. Not long ago, it released Medicare Advantage data, a move that foreshadows next year’s anticipated release of Medicaid and Children’s Health Insurance Program data. If that goes as planned, it will arm researchers and innovators with new information on 74 million people, Verma said.

CMS is also advancing its Blue Button 2.0 application programming interface (API), which it says will ultimately enable Medicare recipients to sync their claims data to third-party apps, including research programs. So far, 600 developers have signed on to work on the API.

What’s more, beginning next year, CMS will require providers to use the 2015 edition of electronic health record (EHR) technology — precisely because it uses open APIs, a technology that CMS considers key to interoperability and data innovation.

All of these efforts — and those that could and should come from private healthcare organizations — are attached to a concrete goal. During her speech, Verma called on attendees to make all doctors’ offices fax-free by 2020.

“As patients, we demand a health IT system that is as advanced as the medical technology that saves lives,” she said. “As regulators, policymakers and IT specialists, it is our charge to make that vision a reality. Let’s get to work.”

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