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Practice Fusion · Jan 31, 2023

Fast Healthcare Interoperability Resources (FHIR)

Fast Healthcare Interoperability Resources (FHIR®) is a Health Level Seven International (HL7®) standard that defines the exchange of healthcare information between multiple computer systems regardless of how it is stored in those systems. This standard ensures that healthcare information, including clinical and administrative data, can be securely accessed by those who need it and for the benefit of patients receiving care.

The adoption of FHIR has helped the healthcare industry improve methods to enable the seamless exchange of healthcare information. The growing amounts of health data in numerous practices have primarily driven the adoption of the technology.

Why should you care about FHIR?

We are certified EHR technology

Practice Fusion is a certified Electronic Health Record (EHR) technology provider as required by the Office of the National Coordinator for Health Information Technology (ONC). Our EHR technology helps your Practice to manage patients and provide better health care by:

  • Providing accurate and up-to-date healthcare records
  • Enabling seamless access to patient healthcare information
  • Providing extra security for the patient’s confidential information
  • Helping practices improve productivity

Practice Fusion has enabled practices and patients to connect to third-party applications using FHIR-standardized Application Programming Interfaces (APIs) as of December 31st, 2022, per ONC certification requirements. The FHIR third-party application API will help practices quickly connect with approved third-party applications as necessary. The API also provides more security for a patient’s confidential information, which means customers can benefit from improved data privacy.

Practices can manage FHIR connections

FHIR supports connected third-party applications’ ability to connect to an EHR. With Practice Fusion, practices have the control to manage all the FHIR connections to their practice’s EHR. This gives practices the privilege of choosing whether data is shared with any given application. Also, the feature has been designed in a way that allows practice administrators to control third-party connections, not just any staff member with access to the practice account.

The technology also allows practices to share a patient’s data with other practices or partners to learn more about a patient’s condition. This helps you provide more personalized and quality care to your patients, improving customer satisfaction and your practice reputation.

Enhanced FHIR features in Practice Fusion

Suppose your practice participates in federal, state, or other programs requiring certified EHR technology (CEHRT). As a participant, you may be required to use the FHIR features. This includes practices using the Alternative Payment Model (APM) or the Merit-based Incentive Payment System (MIPS).

MIPS

This is a feature used to determine Medicare payment adjustments. The program uses a composite performance score where eligible clinicians may receive a payment bonus, penalty, or adjustment. MIPS allows providers to submit Quality, Promoting Interoperability measures, and Improvement Activities collected during the performance year (this is the period in which program participants must collect their Quality Payment Program (QPP) data). The Centers for Medicare & Medicaid Services (CMS) then collects and calculates cost measures for you.

The four performance categories that determine your final score include:

  • Quality - in this category, the quality of the care you deliver to customers will be evaluated based on performance measures developed by CMS and other medical experts and stakeholder groups.
  • Promoting Interoperability (PI) - PI promotes patient engagement and exchanging patient health information electronically using CEHRT.
  • Improvement Activities - in this category, your progress in care processes will be assessed to improve patient engagement and enhance quality care access.
  • Cost - this category will assess the cost of the patient care you provide. CMS calculates cost measures based on your Medicare claims to set the cost of the care you provide to specific patients.

APM

This payment approach gives added incentive to provide high-quality and cost-efficient care. APMs can apply to a particular clinical condition, a care episode, or a population.

Types of APMs:

  • MIPS APMs - this has the Merit-based Incentive Payment Systems’ eligible clinicians participating in the APM on their Centers for Medicare & Medicaid Services’ approved participation list.
  • Advanced APMs - this provides a track of the Quality Payment Program that offers a 5% incentive for achieving threshold levels of payments or patients through Advanced APMs. When you reach these thresholds, you are exempted from the MIPS reporting requirements and payment adjustment (CMS consistently applies adjustments to your Medicare reimbursements on future covered professional services based on your participation and performance in MIPS).

Why is the FHIR standard being implemented in Practice Fusion?

Practices have long been adopting FHIR in response to the growing need for enhanced methods of exchanging patient information and increased health data. Also, the ONC’s Cures Act Final Rule (Cures Rule) supports customers’ and practices’ ability to access electronic health information (EHI) through FHIR-based APIs.

The implementation of FHIR standards in Practice Fusion has been driven by the Cures Rule requirement for particular developers of certified health Information Technology (IT) to provide accredited FHIR API to their customers before December 31, 2022.

What does FHIR mean for me and my practice?

As a practice, you will be able to control and manage FHIR connections in your EHR with some possible use cases for FHIR, including:

  • Patient-facing Applications - will likely include specific applications that patients can use in addition to or as an alternative to Patient Fusion.
  • Provider-facing Applications - will likely include specific applications that Practice Fusion customers can use either as stand-alone applications or as modules within the platform using Substitutable Medical Applications and Reusable Technologies (SMART) on FHIR®
  • System Apps / Bulk Export - consent by payers or Accountable Care Organizations (ACOs) to access large amounts of data.