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ICD-10 Claims Monitoring Infographic

Posted on June 30, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m told that there are only 92 days left for Congress to delay ICD-10 until the deadline to implement ICD-10. A few weeks ago we published a great post from Vishal Gandhi, CEO of ClinicSpectrum, that talked about a part of ICD-10 preparation that is often forgotten: Claims Monitoring.

I know this is going to be a major problem for many healthcare organizations and is going to cause some major cash flow problems if they don’t get on top of their ICD-10 claims by implementing some sort of ICD-10 claims monitoring process. ICD-10 hiccups are the perfect excuse for a payer not to pay your claims.

For those that prefer a more visual approach to this discussion, Vishal and his team have put together an infographic that shares the same message as his post. Pretty cool. What won’t be cool is if you’re stuck with a lot of unpaid claims thanks to ICD-10. Make sure you and your organization are ready to deal with it.
What Are You Doing to Monitor Your Claims

Full Disclosure: ClinicSpectrum is a sponsor of EMR and HIPAA.

2300 Blog Posts and 11 Million Pageviews Later

Posted on June 29, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those that don’t know the history of EMR and HIPAA, I wrote the first post on EMR and HIPAA back on December 11, 2005. It’s fun to read that first post. Short and sweet. I hit some high level points which amazingly still represent my desires 10 years later. “I will try to incorporate any aspects of EMR and HIPAA because I think best practices across the industry are important to know.” – I still try to incorporate any aspect of healthcare IT. Lately I’ve been writing even more about the business of medicine, but I still try and find best practices.

In my original post I invited people to participate in the conversation. I still desire this greatly, but I’ve found that much of the conversation has moved to social media versus the blog comment section. Plus, as I’ve refined my blogging skill, it avoids many comment threads. In the beginning I wasn’t as skilled and so there was a lot of opportunity to correct me which made for great comment threads.

The last line of that original post really expressed my understanding of EHR at the time: “This is my best knowledge from my research and is not guaranteed in anyway.” Pretty funny that I thought to put in a disclaimer from the start. When I started I knew so little. It’s amazing how much you can learn over 10 years. Yet, I’m still learning.

5 months into my EMR and HIPAA blogging journey I celebrated reaching 30,000 visitors to my blog. I was amazed by my achievement. Little did I know that less than 10 years later I’d be celebrating 2300 blog posts and 11 million pageviews. For some perspective, we celebrated 3 million pageviews in August 2010 and then last Valentine’s day we celebrated 9 million pageviews. I was nostalgic for those posts and still am today.

I’m really not sure how to process 2300 blog posts and 11 million pageviews for one of my Healthcare Scene blogs. I mostly feel to say: Thank you!

I never thought I’d be a full time blogger when I grew up, but I feel lucky to do so. Over the past 5 years as a full time blogger, it’s been amazing to see the blogging business model change. When I started blogging people were happy to buy links from my site (We stay far away from that now). We always have done some pay per click and display advertising and those both still do quite well for us. However, as we’ve matured, we’ve been able to offer a variety of email marketing and sponsored content options which really take healthcare IT marketing to the next level.

With that in mind, I want to take a second to thank those companies who are currently supporting the work we do here at EMR and HIPAA. Without their support, none of this would be possible.

EMR and HIPAA Email Sponsors

EMR and HIPAA Sponsored Content Series
The Breakaway Group

EMR and HIPAA Display Advertising
HIPAA Secure Now
Colocation America

What I love about each of these companies is that they are looking to promote their company, but they’re also interested in supporting the work we do here at EMR and HIPAA. Almost all of them are not only sponsors of the site, but also readers of the site as well.

If your company would like to support the work we do here at EMR and HIPAA, we’ve created a new landing page which outlines all of the various healthcare IT marketing and advertising options we offer across the Healthcare Scene network. We’d love to work with you on sharing your message. Just drop us a note on our contact us page.

We’ve got a lot of ideas on how to continue to make what we do here at EMR and HIPAA better. However, what won’t change is our efforts to provide valuable content that helps make our readers’ lives easier.

Starting with Small and Simple Changes

Posted on June 26, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I had the chance to talk with Dr. Adam Sharp, CMO of par8o. While I’d followed at a very high level Dr. Sharp and Dr. Daniel Palestrant’s move from Founding Sermo to the launch of par8o, this was the first time I’d had a chance to really learn what they were doing in their new venture. I’d say that par8o’s core product now is managing the referral process, but they’ve built referral management on a platform that could facilitate all sorts of communication and data sharing across many parts of healthcare.

I love the way they’re approaching healthcare IT because I’ve long believed that many healthcare IT companies are trying to bite off more than they can chew. Many healthcare IT companies have really big visions of how they’re going to solve healthcare’s problems (of which there are many). They raise a bunch of money to go after those problems and then they never really solve anything. In most cases, the healthcare establishment kicks against such massive changes and so it makes it almost impossible for a health IT company to sell such a massive solution.

One reality of life is that we all hate change. This is true even when we know that change is the right thing to do. So, it shouldn’t be any wonder when a healthcare IT company comes in and wants to massively change what we’re doing that they find resistance. I consider that a failed strategy that I’ve seen far too many healthcare IT startup companies employ.

What I heard from par8o is that they’ve taken the opposite approach. They’re focused on a small change that can provide value to a healthcare organization. In this case it’s referral management. When you hear what they’re doing to make the round trip referral and response process electronic, you ask yourself why we haven’t been using technology to do this forever.

I’ve seen over and over again in healthcare IT that these small, simple and almost obvious solutions often make the biggest impact. They make a big impact because healthcare organizations actually adopt them. Dr. Sharp told me that even the small changes they’re introducing often meet resistance from their users. They have to invest a lot of time and effort to overcome that resistance. If even small changes are resisted, you can imagine why massive changes to an organization’s process are flat out refused.

What’s most interesting about this approach is that by successfully implementing these small changes, it opens the door for a company to eventually help a healthcare organization make much larger changes. I’ve often asked healthcare IT companies, what’s your gateway drug? (ie. What feature of your product do they really want to buy that gets them started with you?). Once you get them hooked on a specific feature, then you have the relationship and trust built to be able to offer broader changes.

It seems like par8o has taken the right approach to building trust in and providing value to their customers in referral management. I’ll be interested to watch how they leverage that trust and their healthcare communication and data sharing platform (they call it a healthcare operating system) to optimize other healthcare processes. In a fee for service world many healthcare organizations profited from a lack of optimization. In a new value based care world those optimizations are going to become extremely important.

King v Burwell Decision Teaches Sad Lesson in Law Making

Posted on June 25, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you’re living under a hole (in the healthcare world we call that in the middle of an EHR implementation), the Supreme Court ruled on King v Burwell today. You can read the 47 page document here if you’re interested in the details of the decision. If you’ve ever read a Scalia decision or dissent, then you’ll know what to expect in his dissenting comments.

The reality is that the decision essentially made it a non-event. If they’d decided the other direction, then there would be a lot of scrambling to mitigate the damage of having all the federal health exchanges not be subsidized. That didn’t happen and so ACA (Obamacare) will continue on as before.

I won’t dive into the good and bad of ACA or the efforts to keep it around or get rid of it here. However, the one big takeaway I have from reading the SCOTUS decision is that the law making process is really awful. At one point in the decision they even reference a quote that “we need to pass the law to see what’s in it” which I’m told is a common phrase in Washington. The decision also commented on how the law was poorly crafted because it wasn’t put through the regular congressional procedures.

I understand that the US government has hundreds of years of overhead that they’re dealing with when making laws. A lot of the procedures likely play a critical role in the law making process. However, I feel that the law making process has accrued so much complexity that it makes everything a challenge.

In the tech world we call this situation “technical debt.” Over time as you’re programming a piece of software, you accrue so much technical debt that making changes on the existing code base becomes really expensive. The solution in the software world is often to recode the software from scratch. It’s almost like declaring bankruptcy and starting from scratch.

The SCOTUS decision highlights to me how much legislative debt our government has accrued in their processes. Unfortunately, they can’t declare bankruptcy and start over without the debt. That’s just not feasible or reasonable.

Since I live in the healthcare IT world, we’ve seen a lot of this “debt” impact legislation like meaningful use. We’re going to see more of it around value based reimbursement and ACOs as the healthcare payment world evolves. Government involvement is a reality in healthcare for many reasons including the government being one of the biggest healthcare “customers.” There can be a lot of benefits that come from government involvement, but there can also be a lot of challenges and loopholes that can snag you. That’s the lesson I’m taking from the King v Burwell decision.

How NOT to Do Population Health

Posted on June 24, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The famous world traveler, Dr. Nick (he’s also CMIO for Nuance Healthcare), is attending #AMDIS15 and was kind enough to share out this awesome image:
How to Not Do Population Health

This slide was shared by Coray Tate from KLAS and is a great message to consider.

I also don’t think we should come down too hard on Humana. As healthcare companies start to stretch the normal, stuff like this is going to happen. I think that’s a good thing. At least the diabetic now had a chocolate bar that they could share with someone like me. Then, they’d have a happy friend and making a friend happy is worth so much more than a chocolate bar.

Does Federal Health Data Warehouse Pose Privacy Risk?

Posted on June 23, 2015 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Not too long ago, few consumers were aware of the threat data thieves posed to their privacy, and far fewer had even an inkling of how vulnerable many large commercial databases would turn out to be.

But as consumer health data has gone digital — and average people have become more aware of the extent to which data breaches can affect their lives — they’ve grown more worried, and for good reason. As a series of spectacular data breaches within health plans has illustrated, both their medical and personal data might be at risk, with potentially devastating consequences if that data gets into the wrong hands.

Considering that these concerns are not only common, but pretty valid, federal authorities who have collected information on millions of insurance customers need to be sure that they’re above reproach. Unfortunately, this doesn’t seem to be the case.

According to an Associated Press story, the administration is storing all of the data in a perpetual central repository known as MIDAS. MIDAS data includes a lot of sensitive information, including Social Security numbers, birth dates, addresses and financial accounts.  If stolen, this data could provide a springboard for countless case of identity or even medical identity theft, both of which have emerged as perhaps the iconic crimes of 21st century life.

Both the immensity of the database and a failure to plan for destruction of old records are raising the hackles of privacy advocates. They definitely aren’t comfortable with the ten-year storage period recommended by the National Archives.

An Obama Administration rep told the AP that MIDAS meets or exceeds federal security and privacy standards, by which I assume he largely meant HIPAA regs. But it’s reasonable to wonder how long the federal government can protect its massive data store, particularly if commercial entities like Anthem — who arguably have more to lose — can’t protect their beneficiaries’ data from break-ins. True, MIDAS is also operated by a private concern, government technology contractor CACI, but the workflow has to impacted by the fact that CMS owns the data.

Meanwhile, growing privacy breach questions are driven by reasonable concerns, especially those outlined by the GAO, which noted last year that MIDAS went live without an in-depth assessment of privacy risks posed by the system.

Another key point made by the AP report (which did a very good job on this topic, by the way, somewhat to my surprise) is that MIDAS’ mission has evolved from a facility for running analytics on the data to a central clearinghouse for data sharing between CMS and health insurance companies and state Medicaid organizations. And we all know that with mission creep can come feature creep; with feature creep comes greater and greater potential for security holes that are passed over and left to be found by intruders.

Now, private healthcare organizations will still be managing the bulk of consumer medical data for the near future. And they have many vulnerabilities that are left unpatched, as recent events have emphasized. But in the near term, it seems like a good idea to hold the federal government’s feet to the fire. The last thing we need is a giant loss of consumer confidence generated by a giant government data exposure.

Patients Demand the Best Care … for Their Data

Posted on June 22, 2015 I Written By

The following is a guest blog post by Art Gross, Founder of HIPAA Secure Now!.
Art Gross Headshot
Whether it’s a senior’s first fitting for a hearing aid, or a baby boomer in for a collagen injection, both are closely scrutinizing new patient forms handed to them by the office clerk.  With 100 million medical records breached and stolen to date, patients have every reason to be reluctant when they’re asked to fill out forms that require their social security number, driver’s license, insurance card and date of birth — all the ingredients for identity fraud.  Patients are so squeamish about disclosing their personal information, even Medicare has plans to remove social security numbers on patients’ benefits cards.

Now patients have as much concern about protecting their medical records as they do about receiving quality care, and they’re getting savvy about data protection.  They have every right to be assured by their physician that his practice is as concerned about their privacy as he is about their health.

But despite ongoing reports of HIPAA violations and continuous breaking news about the latest widespread patient data breach, medical practices continue to treat ePHI security as a lesser priority.  And they neglect to train front office staff so the patient who now asks a receptionist where the practice stores her records either gets a quizzical look, or is told they’re protected in an EHR but doesn’t know how, or they’re filed in a bank box in “the back room” but doesn’t know why.

In some cases, the practice may hide the fact that office staff is throwing old paper records in a dumpster.  Surprisingly this happens over and over.  Or, on the dark side, the receptionist accesses the EHR, steals patients’ social security numbers and other personal information and texts them to her criminal boyfriend for medical identity theft.

Another cybercrime threatening medical practices comes from hackers who attack a server through malware and encrypt all the medical files.  They hold the records hostage and ask for ransoms.  Medical records can vanish and the inability to access critical information about a patient’s medical condition could end up being life threatening.

Physicians should not only encrypt all mobile devices, servers and desktops, regularly review system activity, back up their servers and have a disaster recovery plan in place, etc. they should also share their security practices and policies with the patient who asks how his office is protecting her records.

Otherwise, the disgruntled patient whose question about security is dismissed won’t only complain to her friends over coffee, she’ll spread the word on Facebook.  Next time a friend on Facebook asks for a referral the patient tells her not to go to her doctor — not because he’s an incompetent surgeon but because he doesn’t know the answer when she asks specifically if the receptionist has unlimited access to her records.

And word gets out through social media that the practice is ‘behind the times.’  The doctor earns a reputation for not taking the patient’s question seriously, and for not putting the proper measures in place to secure the patient’s data.  This is the cockroach running through the restaurant that ends up on YELP.

It’s time to pull back the curtain and tell patients how you’re protecting their valuable data.  Hand them a HIPAA security fact sheet with key measures you’ve put in place to gain their confidence.  For example, our practice:

  • Performs annual risk assessments, with additional security implemented, including encryption and physical security of systems that contain patient information.
  • Shows patients that the organization has policies and procedures in place
  • Trains employees on how to watch for risks for breaches
  • Gives employees limited access to medical records
  • Backups systems daily
  • Performs system activity regularly

Practices that communicate to patients how they are protecting their information, whether it’s provided by the front office staff, stated in a fact sheet or displayed on their websites, not only instills confidence and maintains their reputations, they actually differentiate themselves in the market place and attract new patients away from competitors.

About Art Gross
Art Gross co-founded Entegration, Inc. in 2000 and serves as President and CEO. As Entegration’s medical clients adopted EHR technology Gross recognized the need to help them protect patient data and comply with complex HIPAA security regulations. Leveraging his experience supporting medical practices, in-depth knowledge of HIPAA compliance and security, and IT technology, Gross started HIPAA Secure Now! to focus on the unique IT requirements of medical practices. Email Art at

Full Disclosure: HIPAA Secure Now! is an advertiser on EMR and HIPAA.

Downsides of Incorporating Behavioral and Social Data Into an EHR

Posted on June 19, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In response to my post about incorporating behavioral and social data into EHR, I got the following email from one of our readers:

My worry on the collection of such behavioral and social data is that it will get used to further prescribe people with the psychiatric drugs that have such horrendous side effects to the benefit of big pharma rather than move towards diet, health education, nutrition and other non-medical remedies that can have long lasting benefits for a lifetime.

It’s a very fine point. In my previous article I didn’t spend enough time talking about the potential downsides of incorporating all that data into an EHR. The reader pointed out the potential abuse by big pharma to sell more drugs. No doubt, pharma is trying to sell more drugs. I’m sure the creative minds at pharma will try and find ways to leverage this data and sell more drugs. That’s the nature of healthcare.

However, I think pharma would try to do this whether the data was in the EHR or not. In fact, having this data in the EHR for the doctor might mean the doctor makes better choices and doesn’t always default to pharma to treat a patient. For example, if you know they’re living in a poor area, then you can ask them if they have enough food or heat in the winter in order to avoid them returning to you a few weeks later with another cold. This would actually lead to less drugs because you’re actually treating the cause of the problem as opposed to just the presenting problem.

While this example paints a pretty picture, you could also paint an awful picture where this data is used for discrimination. This could be in the office itself or by insurance companies. Some of the new ACA laws help when it comes to insurance discrimination, but many fear that the move to ACOs will cause these organization to discriminate against the unhealthy and poor. I have this fear as well. When you pay to keep people healthy, who do you want to have in your patient population? The healthy.

When you start talking about including all this new data in an EHR, there are a lot of privacy and security questions that come up as well. We’ve always known that the patient record was a treasure trove of personal information that needed to be safeguarded and protected from abuse. Social and behavioral data makes the health record even that much more desirable to nefarious groups who want to abuse the data. HIPAA along with privacy and security will become that much more important.

I’m sure I’m just touching the surface on the challenges and problems associated with all this new data. Although, the thing that scares me most is the way people could abuse the data. I don’t think these are reasons to not use this data. We need to use this data to move healthcare forward. However, it is a call to be very thoughtful about how we collect, secure, and use the data we’re collecting.

What Are You Doing to Monitor Your Claims?

Posted on June 18, 2015 I Written By

The following is an interview with Vishal Gandhi, CEO of ClinicSpectrum as part of the Cost Effective Healthcare Workflow Series of blog posts. Follow and engage with him on Twitter @ClinicSpectrum and @csvishal2222.
Vishal Gandhi
As practices prepare for the rollout of ICD-10, we’re seeing practices and hospitals make investments in upgrades to their technology to be able to support ICD-10. They’re investing in ICD-10 training in order to be ready for ICD-10. Some are even spending time and resources dual coding to make sure they’re ready for the change. While each of these are important, it’s surprising to me that we don’t see more healthcare organizations budgeting for additional help in following up with insurance companies to make sure that claims are being processed.

From my experience across hundreds of healthcare organizations, I’ve found that 20-25% claims are stuck in cyberspace at any one time. I’m talking about claims that practices assume have been delivered to the insurance company and are being processed, but instead the insurance company never received them or the claim was missing something and has gotten stuck in the insurance company’s claim process.

How many practices have a process for ensuring that their claims are being processed efficiently and effectively? Not many. That means they aren’t getting paid in a timely manner and in some cases aren’t getting paid at all.

When we send off an email or SMS, we don’t really think about whether those things are delivered to the recipient or not. We trust that they’re going to get there without issue because they usually do. It seems we’ve applied that same confidence to claims and that’s a problem. We can’t trust that claims have actually been delivered appropriately and are being processed since there are so many ways that they can fall through the cracks.

On October 1, 2015 (assuming no delays), ICD-10 is going to make this problem even bigger. ICD-10 presents a tremendous opportunity for insurance companies to lose more of the claims you’ve submitted. If you’re not checking with the insurance company regularly, you’ll have no way of knowing if an insurance company’s switch to ICD-10 has caused a glitch in their claims processing or not. The insurance company won’t care because the practice or hospital will be the ones left holding the bag.

This problem can be solved pretty easily. Your practice just needs to randomly select 100 or so claims and call (or hire an outside company to call) each insurance company to get an update on the status of those claims and verify that the claim is being adjudicated. We suggest you do this about 10-20 days after the claim is filed.

By checking on these claims, you’ll pretty quickly see which insurance companies are processing claims effectively and which ones are having issues so you can address the problem(s). Plus, you can evaluate if there are any workflow issues on your end with the claims your submitting.

Especially as we start implementing ICD-10, but also today it’s extremely important to verify how well your claims are being processed. If you’re not doing so, you’re probably not getting all your claims paid in a timely manner and could be missing out on additional revenue for your practice.

The Cost Effective Healthcare Workflow Series of blog posts is sponsored by ClinicSpectrum, a leading provider of workflow automation solutions for healthcare. ClinicSpectrum offers a Claims Watchdog service which monitors your claims for you to ensure you’re getting paid in a timely manner. Connect with Clinic Spectrum at HFMA ANI 2015 in Orlando, Booth #1256 or by tweeting @ClinicSpectrum.

Interoperability of Electronic Health Records– Benefits and Opportunities – Breakaway Thinking

Posted on June 17, 2015 I Written By

The following is a guest blog post by Jennifer Bergeron, Learning and Development Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Jennifer Bergeron
Electronic health records (EHR) aim to improve healthcare and processes for providers and patients on a number of fronts. In an ideal situation according to, the clinician benefits by having quick access to patient records and alerts, the ability to quickly and accurately report, and a path to safer prescribing. Patients should be able to spend less time filling out duplicative forms at clinics, have prescriptions sent automatically to pharmacies, and gain easier access to specialist referrals.

The International Journal of Innovation and Applied Studies points out that interoperability can work toward a resolution to several current problems including patient record accessibility and consolidation, and healthcare costs. As far as getting patient information and all available information when it’s needed, the report “estimated that 18% of medical errors that result in an adverse drug event were due to inadequate availability of patients’ information.” Healthcare costs are reduced when different entities can share and communicate common data and could save up to $77.8 billion annually.

Given the potential benefits, there are still opportunities to achieve interoperability. For example, not all healthcare organizations are using EHRs so data isn’t being collected consistently across the board. In 2014 there was an increase in the percentage of hospitals with EHRs. However, only 39% of physicians reported that they share data with other providers. Even though the data is available to share, some EHR users may still be living in a silo and haven’t reached full adoption. In addition, existing specification standards have not promoted interoperability. Even though there is data is available to share, few providers are tapping into that information.

To help increase data sharing, more attention is being paid to FHIR, or Fast Healthcare Interoperability Resources. FHIR stems from HL7 (Health Level Seven) data exchange and information modeling standards. HL7 has been around since 1987 to develop families of standards used to automate healthcare data sharing with the goal to improve patient care. FHIR builds upon the interoperability uses of HL7 and takes into consideration the changes in technology and requirements. According to the Office of the National Coordinator for Health Information Technology (ONC), FHIR is used to enable data access, is used as the container to return query results, and will be used to build necessary security and privacy controls.

FHIR combines what are called “resources” — also known as an instance of data – that define data and are used for specific content. Within a resource are characteristics including “a common way to define and represent them, building them from data types that define common reusable patterns of elements, a common set of metadata, and a human readable part.” Collected data can be used and exchanged, searched for individually or in groupings, analyzed and examined.

Interoperability and the role of FHIR is not yet clearly defined. Going forward, the roadmap for interoperability built by the ONC will be watched closely. Guidelines are broad at this point to allow appropriate decision-making as paths are forged. A group of organizations called the Argonaut Project has committed to working with FHIR. defines the Argonaut Project as having the purpose of developing “a first-generation API (application programming interface) and Core Data Services specification to enable expanded information sharing for electronic health records, documents, and other health information based on the FHIR specification.”

APIs are at work behind the scenes when we’re accessing information online. Although healthcare is beginning to harness the power of APIs these interfaces are present everywhere in our day-to-day lives. For example, say you are listening to Spotify and want to connect that application with Facebook. An API helps make that translation of information from Spotify to Facebook happen.  Imagine the possibilities in the realm of data and healthcare. The development of APIs by the Argonaut Project is just the beginning stages of data sharing and interoperability.

In order to reach true interoperability and efficient use of FHIR, the first step is EHR adoption. Once data is captured into an EHR system, organizations can focus on data standards and clear data management, and have the ability to measure impacts to healthcare patients, providers, costs, and communication. Without the right, accurate data input, interpretation at the end of the process is not accurate or actionable. If clinicians are aware of how their engagement with data and proper input at the beginning of this process affects their practice, their patient’s experience and health, and healthcare on a broad spectrum, they can make a difference well into the future.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.