LAS VEGAS – At HIMSS25 last week at HIMSS25, a panel of healthcare interoperability leaders convened for an ad hoc discussion about the continued evolution of FHIR API-based data exchange. The next ten years or so.
Session moderator Leavitt Partners Principal Ryan Howells emphasized that panel talk is not a political debate. The session, “Dropping the Clipboard: Doge and the Trump Administration's Policy Ideas” shares the name with the recent Leavitt Partners Whitepaper, which served as the basis for the discussion.
“The election is over,” Howells said. “We are now in the next four years of administration priorities, the next four years. This is not a political discussion in terms of what is right, what is wrong, what is going on with the administration. It is a discussion of how this administration's priorities and how to align the tech interactional policy in advance.
“It's clear that they want to do something big and bold, and that they are actually making generational changes in the federal government,” he explained. It is clear that they actually want to eliminate waste. They are clear. The question is to understand what these priorities are and how to actively provide recommendations that will allow the ball to move meaningfully in terms of interoperability and policy over the next decade or more. ”
Howells is joined by Michael Westover, Providence's vice president of population health. Anna Taylor, VP of Population Health and Value-Based Care at Multicare Connected Care. Jason Teeple, interoperability strategy leader and senior director for Cigna Healthcare's enterprise architecture.
Among the questions they tried to answer, what federal technology policies are needed or no longer needed to create a truly patient-centered healthcare system? How should CEHRT evolve to support the latest API-based interoperable ecosystem? And what can we expect from the new administration in this respect over the next few years?
“What will we need to do over the next decade?” asked Howells. “Not the next administration, not the next few years. What should we do to significantly advance data interoperability and data exchange over the next decade?
“And when we think about it, what will this look like over the next decade? We need to really expand our ideas in terms of what we need. You need to see all the great vendors on the show floor there.
Howells argued that current interoperability policies are “outdated” and that there are simply many of them.
“There are too many regulations,” he insisted. And we have a lot as we start growing from a particular program, starting to prove the individual features within the EHR, and starting to add a lot to build the EHR.
“Well, now we've built them. We now need to figure out how to move data between systems. We have no issues building the functionality of our EHR. We have the problem of exchanging data not just between EHRs, but with payers, patients, patients and everyone else.
Howells also advocated to resolve policies and some discrepancies between different agencies and remove better integrity regarding the timing of rules compliance.
“We're a bit out of sync based on policy from a timing standpoint,” he said. For example, “When USCDI is in place, when CMS rules need to be advantageous. That's the nature of the federal government.
He also said they need to move towards a “more modern computing architecture.”
“We believe we need to redefine CEHRT,” Howells said. “We return to the original definition of the Hitech Act, which describes hardware, software, or packaging solutions sold as services designed or supported by healthcare entities or patients for electronic creation, maintenance, access, or electronic health information.
“I'm not saying that it's EHRS. It could be EHRS. It could be a payer. It could be a cloud-based solution. It could be someone else. So, if we think about it, if we start redefine the API and certify the API, which is an outbound call for the API, then it's not a proof of the API's internal functionality, it's a different paradigm.”
