North America

CMS launches new API to help doctors get access to patient records

The program is designed to help providers gain additional insights into a patient's health records without changing their workflows.
By Laura Lovett
12:19 pm

Looking to solve the problem of health record interoperability, this afternoon CMS unveiled a new pilot program dubbed “Data at the Point of Care” (DPC), which will employ an API to help give providers access to their patient’s medical data. The pilot is part of a larger CMS initiative called MyHealthEData, which is focused on giving patients more access to their medical data. 

“That burden on patients can be really heavy,” Shannon Sartin, executive director of the Digital Service at the Department of Health and Human Service, told MobiHealthNews.  “So we really wanted to just take CMS claims data and build a tool that could be used by clinicians to kind of fill in these gaps. And physicians provide insights into where initial data they want is, what data integration is available in claims that could be really beneficial in the delivery of care, and also set a model of what interoperability and data sharing in healthcare could really look like.”

Eventually the goal is to give providers information about patients including past diagnosis, tests and trends. 

“What we are launching on [July] 30 is the pilot program for this API that will deliver data directly to providers at the point of care via the technology they are already using,” Sartin said. “So, not building a separate tool that they have to log into, but really saying, ‘Can I shoot you over a stream of data that you can pull up in your own workflow right now if it adds value, and/or ignore it if it doesn’t?’ It’s not a mandatory thing but it should definitely be something that is available.” 

Starting today providers can apply to be part of the pilot. In the first stage of the pilot providers will get access to synthetic or fake data to test out. Around the September-to-October timeframe, providers who already tested the synthetic data will be included in the rollout of real data.

“If you think about all of that data that is in different silos with different providers that patient may see, we think the average is seven doctors per Medicare patient that they see on average. The doctor will be able to request any patient that is seen under expert treatment or that they have an upcoming appointment for,” Amy Gleason, digital service expert at the US Digital Service, told MobihealthNews. “They could ask for information on those patients using the bulk API, and then CMS will evaluate whether they have access to that information based on the treatment rules under HIPAA. Then they will get that information back by bulk response.”


It’s no secret health record interoperability has posed a number of hurdles for patient care in the US. The lack of connected health records has put the pressure on both patients and providers to wrangle health information. 

“One of our big initiatives is to remove provider burden, but we’d also like to remove patient burden,” Gleason said. “As patients go through the healthcare system, they have to retell and remember their medical history [for] every provider they see.” 

While this pilot is focused specifically on the Medicare population, it could be a model for providers in the future. 

“It is an interesting opportunity for an agency that technically has fallen behind a little to really step up and say ‘Hey, we are going to be really forward leaning and we are going to be the ones really blazing this path,’” Sartin said. “From my perspective, that is such an impressive thing for CMS to be doing … it really is a big deal for healthcare, for a payer." 


CMS has had a focus on removing interoperability barriers for some time. This project is part of the Blue Button Programa government effort dedicated to giving patient’s access to their own health data. CMS also launched MyHealthEData at HIMSS18, in an effort to get information into the hands of patients faster. As part of that plan, patients were able to get a copy of their entire health record electronically via program interfaces or APIs. 

At that same event CMS Administrator Seema Verma announced that Blue Button is being upgraded to Blue Button 2.0. This was followed by an announcement at last year’s Blue Button 2.0 Developer Conference that Amazon, Google, IBM, Microsoft, Oracle, and Salesforce came together to pledge to remove interoperability barriers. 


“This pilot program is another example of how the Trump Administration is doing everything possible to bring our healthcare system into the 21st century,” CMS Administrator Seema Verma said in a statement. “Technology, coupled with open data sharing, is how we will improve value, control costs and keep patients healthy while ensuring a solvent Medicare program for generations to come.”


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