Interoperability and Patient Access to Health Data: New Proposals

February 28, 2019
Policy Snapshot

The Centers for Medicare & Medicaid Services (CMS) proposed policy changes supporting the MyHealthEData initiative to improve patient access and advance electronic data exchange and care coordination throughout the health care system. The Interoperability and Patient Access Proposed Rule outlines opportunities to make patient data more useful and transferable through open, secure, standardized, and machine-readable formats while reducing restrictive burdens on health care providers.

In addition to the policy proposals, CMS released two requests for information to obtain feedback on:

  • Interoperability and health information technology adoption in post-acute care settings
  • The role of patient matching in interoperability and improved patient care

“For far too long, electronic health information has been stuck in silos and inaccessible for health care consumers,” said CMS Administrator Seema Verma. “Our proposals help break down existing barriers to important data exchange needed to empower patients by giving them access to their health data. Touching all aspects of health care, from patients to providers to payers and researchers, our work leverages identified technology and standards to spark new opportunities for industry and researchers while improving health care quality for all Americans. We ask that members of the health care system join forces to provide patients with safe, secure access to, and control over, their health care data.”

Proposed Changes and Updates:

  • Patient access through Application Programming Interfaces (APIs)
  • Health information exchange and care coordination across payers
  • API access to published provider directory data
  • Care coordination through trusted exchange networks
  • Improving the dual eligible experience by increasing frequency of federal-state data exchanges
  • Public reporting and prevention of information blocking
  • Provider digital contact information
  • Revisions to the conditions of participation for hospitals and critical access hospitals
  • Advancing interoperability in innovative models

For more information: