Written by Dave Nyczepir

The number of third-party applications using the federally mandated data exchange standard to connect to certified electronic health records (EHRs) remained virtually flat in 2020, according to a recent study by the Office of the National Coordinator of Health Technologies. health information.

Only 161 of 734 unique apps, 21.9%, used Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR), compared to 112 of 600 apps, 18.7%, in 2019.

The measure establishes a baseline for the ONC to monitor the implementation of its final rule of the Cures Act, which requires many certified healthcare IT developers to support application programming interfaces. (APIs) standardized on FHIR for patient and population level services by the end of 2022..

“While progress has been made, there is still room for growth and variation exists among some of the biggest EHR developers,” reads the study published in the Journal of the American Medical Informatics Association. at the beginning of the month. “Monitoring the impacts of the rule will be important in determining whether the goals of expanding patients’ access to their electronic health information will be met. “

Potential reasons for the slow adoption of FHIR are the fact that most common administrative applications generally do not support the standard, and those that do are developed around a specific set of use cases and applications. ‘data elements. FHIR-enabled applications are expected to grow with new use cases, according to ONC.

On the bright side, the number of unique apps incorporating certified EHRs has increased to 134 and the number of developers to 93 in 2020. ONC determined this by analyzing the apps in the galleries maintained by the developers of DSE Allscripts, athenahealth, Cerner Corp. and Epic Systems Corp., as well as the SMART Application Gallery.

Of all the applications, 42% were for planning, recording and invoicing; 38% to clinical functions such as automated tasks, population health, telehealth and clinical decision support; 31% in the management of care; 20% to patient engagement; and 5% to research.

The ONC continues to work with agencies, industry and academia to improve the use of and access to electronic health information, including patient access, through the adoption of the FHIR .

The vast array of existing APIs has increased costs and barriers to sharing, which is why the 21st Century Cures Act of 2016 required IT developers to publish APIs that allow access, exchange, and use. health information without “special effort”.

In this context, the final rule of the ONC Cures Act published in May 2020 was designed to advance interoperability by creating certification criteria for the health information technology certification program, in particular by requiring the use of the FHIR standard.


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