CMS Interoperability Empowering Providers with Seamless Access to Patient Data
AI Summary
The video explains the Provide Access API, part of the CMS 0057F final rule, which enables healthcare providers with treatment relationships and agreements with payers to securely access comprehensive patient health information through standardized FHIR-based APIs. This access is especially important for new patient visits or when patients have received care across multiple providers, allowing for complete longitudinal health records beyond local EHR data. The video uses a case study of Dr. James Smith and patient Jack Sha to demonstrate how the API facilitates real-time retrieval of patient encounter data from the payer’s FHIR server to support informed clinical decision-making and coordinated care. The workflow involves the EHR app triggering bulk data export requests, the payer’s FHIR server generating and making the data available, and the provider’s local FHIR server transforming the data for display in the EHR. Key components include the bulk export client, EHR app, local FHIR server on the provider side, and the FHIR server and output file server on the payer side. The system ensures secure, standards-based data exchange complying with the CMS 0057F deadline of January 1, 2027, while enabling better care coordination, reducing duplication, and empowering patients with information on data sharing and opt-out rights. WSO2 accelerator for healthcare is highlighted as a solution supporting CMS compliance and interoperability.