Driving Interoperability in Healthcare, with Tata Consultancy Services & 1upHealth

Driving Interoperability in Healthcare, with Tata Consultancy Services & 1upHealth

Tata Consultancy Services (TCS) is an Information Technology (IT) services and consulting company, who provide their clients with tech expertise and business intelligence to offer innovative solutions through consulting and IT services. They work with a vast array of industries, including life sciences and healthcare as well as HiTech, transforming business models in order to deliver more affordable services whilst improving patient outcomes and supporting value-based care.

1upHealth recently became a TCS COIN™ Partner, and are working together with TCS towards a shared vision of achieving interoperability within healthcare. We are joining hands to standardize healthcare data communication across the vast array of stakeholders in the healthcare industry, and further the need to standardize the healthcare interoperability space for patients, providers and developers. With interoperability, healthcare can work towards a goal of truly value-based care, meaning drastically improving the quality of lives through more patient-focused care, whilst reducing costs for stakeholders.

Recently, there have been rules put into effect which will dramatically help achieve interoperability goals. In March of 2020, the Centers for Medicare and Medicaid Services (CMS) introduced the Interoperability and Patient Access Final Rule, which will have a substantial impact on stakeholders within the U.S. healthcare system, notably CMS-regulated health plans and hospitals. This, in conjunction with the ONC’s Cures Act Final Rule, which ensures patients and their providers secure access to their own health information, has provided the roadmap for interoperability.

To discuss interoperability within healthcare and these final rules in detail, 1upHealth & TCS recently collaborated on a webinar, Pathway to Interoperability. To learn more, you can watch the webinar, or read a short summary of what was discussed below:

Speakers:

  • Ricky Sahu, CEO of 1upHealth
  • Alison Schambach, Director of Healthcare Practice at Tata Consultancy Services (TCS)
  • Viswanathan Ganapathy, Chief Architect & Principal Consultant at Tata Consultancy Services (TCS)

Summary of Webinar

CMS Regulations

Today, the healthcare system remains disparate due to issues surrounding the sharing of health data. Everyone can recognize that as a patient, it is essential to be able to share all your healthcare information. However, it is difficult to be in a situation where you need to coordinate between various health systems such as hospitals, providers and pharmacies. It becomes tedious and tiring to get the care that you need, in the moments that you need it the most. Thankfully, ONC & CMS worked together to come up with the Final Rules to help make the exchange, sharing and aggregation of health data more interoperable.

CMS’s Interoperability and Patient Access Final Rule applies to Medicare, Medicaid and federal health exchanges, making sure that patients have access to their own health information. As a part of these new regulations, health plans now must share clinical and claims data and provider information using FHIR® APIs. FHIR® (Fast Healthcare Interoperability Resources), is a standard that allows for easy exchange of data between EHRs (electronic health records), enabling developers to build applications that exchange data using modern web technologies (like HTML, JSON, XML, OAuth, etc), instead of confusing and outdated clinical languages. Such regulations pave the way for making healthcare more patient focused, as it allows the patient to have more control over their own information, such as who sees and has access to it.

Approach Towards Interoperability, with FHIR

One of the key approaches towards interoperability, is the FHIR standard. FHIR allows the ease-of access which allows one to see their own health data, through data fluidity and liquidity, allowing the exchange of data to become more seamless. This allows Organizations to focus their efforts on reducing the gaps in care and therefore improving healthcare outcomes, whilst reducing the complexities that currently exist with data integration.

At 1upHealth, our FHIR® API platform, currently spans across 10,000+ health centers. Our platform allows any developer or health system to collect patient data within minutes, where our clients can build applications and interfaces. Our platform is deployed using serverless architecture that relies on the cloud, meaning that we have a much faster response time, linear scalability, and stronger security with zero down time. As a health plan, you do not want to deal with bottlenecks, as everyone wants data in real time, and that is what 1upHealth has built our infrastructure for.

Sharing of Patient Data & Considering HIPAA

As health data becomes more patient-mediated, it is important to note that we are entering a new era. Currently, HIPAA protects information between two entities, not necessarily with the patients explicit consent. Patient mediation through apps, now means that the patient is the one in control of who they allow to access or share their data.

When it comes to healthcare apps, individuals need to be able to authorize a third party app to connect to a health plan. For example, when an app requests data (such as EHR, or claims) from another health plan, helps someone find the best healthcare provider for them based on past medical conditions, or if someone simply wants to share their health data with a provider or family member, this data would be consented through a third party app. Therefore, it is essential to consider that patients must be able to trust these apps, and their privacy regulations, as such apps are not currently bound under HIPAA.

Interoperability & TCS

Healthcare tends to be a little bit more behind when it comes to innovations in technology. Thus, TCS provides experience from working on banking projects, learning from pain points when it comes to interoperability and then applying this to the healthcare space. For TCS, it is an exciting time to work with the healthcare industry, as interoperability becomes more streamlined through regulations such as those mandated by ONC and CMS.

"Interoperability will transform the healthcare industry allowing health data to be communicated real-time. This will change how healthcare is delivered giving people and populations more control and insights which means more proactive care."

-Alison Schambach, Director of Healthcare Practice at Tata Consultancy Services

Businesses in health IT play a crucial role in understanding interoperability in order to ensure maximum benefit for businesses as well as customer or patient outcomes and experiences. In order to fasttrack the growing need for faster and more accessible healthcare, interoperability is the key. As new regulations are established, the future of interoperability will help to break the barriers in health systems across the U.S., ultimately enabling faster and more accurate sharing of patient’s healthcare data, whilst also reducing costs and the work burden on both providers and payers.

To listen to the Q&A, or to learn about the technicalities behind interoperability, FHIR, and the Final Rules, you can watch the webinar here