The Future of Post-Acute Interoperability

(KIRKLAND) November 2nd, 2020 – The HL7 FHIR Connectathon event happens three times a year in cities all around the world. This year the conference was virtual because of the COVID-19 pandemic. HL7 is the organization that is responsible for the ongoing development of FHIR (Fast Healthcare Interoperability Resource). FHIR is quickly becoming the new standard for healthcare interoperability, and because of a final rule released by the ONC this year, it should continue to gain rapid momentum.

The promise of FHIR is a modern REST-API-based architecture for communicating highly structured healthcare information using standard web protocols (HTTPS). HL7 coordinates the specification of standardized resources to facilitate this interoperability. HL7 provides a structure for many different groups of stakeholders to collaborate and ultimately vote on what standards should be created and how they should evolve over time.

The purpose of the HL7 FHIR Connectathon is to improve the quality of FHIR specifications through testing connections between different pieces of software. A Connectathon is broken up into different tracks that test different projects. One of the most exciting projects that participated in the Connectathon was the PACIO Project.

The PACIO Project is coordinated by a group of organizations led by The MITRE Corporation and sponsored by the Centers for Medicare & Medicaid Services (CMS). The purpose of the project is to advance interoperability between post-acute care, other providers, and patients. All PACIO documents and resources are open source to promote wide adoption.

Some key concepts of the PACIO Project are:

• The patient should be at the center of healthcare information exchange

• Structured data about a patient’s plan of care and status should be readily available

• Health information should be accessible to the patient and/or their designated representative through a centralized, user-friendly portal

The PACIO team that participated at HL7 Connectathon 25 was focused on creating a proof-of-concept that demonstrates the use of FHIR to exchange data for two purposes:

1) Integration of CMS assessment data elements from the Data Element Library (DEL) into health IT systems

2) Exchange patient level Cognitive and Functional Status data between multiple health IT systems for consumption by clinicians, patients, and their representatives

Both of these purposes coalesce around assessment requirements established by the IMPACT Act of 2014. CMS developed standardized patient assessments in several categories, including Cognitive and Functional Status for exchange between different stakeholder groups, including patients. The PACIO team was able to demonstrate that both purposes could be managed using FHIR resource implementation as specified by PACIO’s current implementation guides. They did this using simulated version of real health IT software facilitated by stakeholder representatives with the different software companies.

Though the PACIO team’s work is not yet being used in any health IT production environments, it represents a bright future where health information exchange can be fast, standardized, and accessible to all stakeholders. The PACIO team also demonstrated a patient-facing portal that reported the FHIR-exchanged assessment data into a very organized and navigable user-interface that appeared well-suited for use by clinicians and approaching a functional state for patient consumption as well. It was very exciting to see this work take shape as part of this proof-of-concept.

It is AIDA’s goal to participate actively in the PACIO Project in the coming months as it is very well aligned with our company goals and roadmap for the future. For those of you who have personal experience working in the post-acute world, as I do, I’m sure you are aware of the many challenges that are faced by clinicians and their support staff when it comes to collection, interpretation, and conveyance of healthcare information. AIDA is a leader amongst a new and powerful crop of software tools that will facilitate much more efficient and transparent exchange of vital information. The work that HL7 International and the PACIO Project is doing is foundational to many improved patient outcomes facilitated by companies like AIDA Healthcare and others.

At AIDA, our purpose is to advance user-friendly, FHIR-focused interoperability between acute and post-acute settings. Today, our focus is on care management and referral management for continuously growing number of care provider types. Looking forward, we anticipate a shift in focus toward patient-facing interfaces and broadened support for leading EMRs. If you would like to learn more, please visit aidahealthcare.com or send me a note on LinkedIn.

PACIO is a trademark of MITRE and is used with permission from The MITRE Corporation.