CMS and ONC's recently released interoperability rules will give patients more power and access over their medical data, leading the shift to consumer-driven competition in healthcare, David Blumenthal, MD, former National Coordinator for Health IT, wrote in an article for Harvard Business Review.
The rules, which support the MyHealthEData initiative and 21st Century Cures Act, would give patients access to their electronic health data at no cost, creating the "potential to open up the healthcare marketplace to consumer-driven competition in ways never seen before in the history of medicine in the United States or anywhere," Dr. Blumenthal wrote in the article.
Per CMS' rule, enrollees in Medicaid, the Children's Health Insurance Program, Medicare Advantage plans and Qualified Health Plans would gain electronic access to their medical claims and other health data by 2020. Additionally, CMS proposed healthcare providers and plans initiate open data-sharing technologies to more effectively support patient care transitions.
"One reason that healthcare markets are so flawed and inefficient is that consumers and patients lack the knowledge to make good choices," Dr. Blumenthal wrote. "In particular, they lack data about their own health and about the health and economic consequences of their decisions. The EHR and these new federal rules could change that fundamentally by giving patients unprecedented access to the information they need to be wise consumers of healthcare."
ONC also proposed the healthcare industry implement standardized application programming interfaces so patients can more easily access their electronic health information. Allowing patients more open access to their electronic health data opens the door for IT companies, which can assist individuals by collecting and managing their data as an authorized third party, Dr. Blumenthal wrote.
IT companies have increasingly ramped up efforts in the healthcare space, such as Apple hiring of dozens of physicians to its staff in 2018. By bringing clinicians onboard, IT companies hope to gain better technical and scientific understandings of healthcare.
"[IT companies'] apparent goal is to assemble patients' clinical data, the best science, and the many other data resources available to savvy IT companies, and then to mix in artificial intelligence, machine learning, and their skill in making consumer-friendly software," Dr. Blumenthal said. "The hoped-for result is usable, timely, patient-empowering decision-support tools that are game-changing for healthcare and healthcare markets."
While digitizing patient records can improve individual access to electronic health information, involving third parties like IT companies can introduce threats to patient privacy and security, Dr. Blumenthal concluded.
To access Dr. Blumenthal's full article, click here.