A blog about the latest updates, stories and ideas from the OneRecord team.

The latest updates, stories and ideas from the OneRecord team.

The OneRecord Blog

OneRecord signs the CARIN Code of Conduct as one of its earliest adopters.

CARIN Code of Conduct signed by OneRecord

Chief Barketing Officer

At OneRecord, our users are the center of everything. We understand their experiences personally. We treat them as equal participants on our mission to transform the healthcare system into a consumer-focused one. This includes being transparent about the relationship between their data and our platform. We don’t believe anyone should have to trade privacy for access to services. Our goal at OneRecord is simple. To build the best products for accessing and managing your health data, without compromising privacy and security. 

On December 1, 2019, as part of our ongoing effort to lead the way for best practices built on a foundation of privacy and security have signed the CARIN Code of Conduct. We are proud to be early adopters and look forward to our continued involvement in the CARIN Alliance and the CARIN Code of Conduct. 

The CARIN Alliance, a multi-sector group of more than sixty health care and other stakeholders managed by Leavitt Partners, has released the CARIN code of conduct for how entities not covered by the Health Insurance Portability Accountability Act (HIPAA), such as third-party applications, can voluntarily handle health care data on behalf of consumers. For the first time, health care organizations and other organizations can have an enforceable code of conduct for third-party applications not covered by HIPAA to self-attest to in order to access health care data on behalf of consumers.

Supportive of recent legislative statutes, such as the 21st Century Cures Act, and ongoing regulatory measures, application programming interfaces (APIs) are being implemented by health care organizations across the country to allow consumers to access their health information on a third-party application of their choice. When personally identifiable health information is shared with applications, that information is considered consumer data and falls outside of the industry's current privacy and security practices under HIPAA. The CARIN code of conduct addresses how health care data should be handled by consumer-facing applications under Section 5(a) of the Federal Trade Commission Act, which encourages industry to develop consensus for what is meant by "unfair or deceptive acts or practices.

The CARIN code of conduct is based on a central theme – third-party applications need to ensure consumers, or their authorized caregivers, provide informed, proactive consent for how their health care data is collected, used, and shared, giving consumers complete access and control over the use of their health care data by entities not covered by HIPAA.

Want to read the full press release about the CARIN Code of Conduct? Click Here

Early Adopters: OneRecord signs the CARIN Code of Conduct

Recognized as a leader in Personal Identity Products, OneRecord was given the 2019 Identity Landscape Award.

Identity Landscape Award given to OneRecord

New York City, New York — November 21, 2019 - OneRecord today announced that it was recognized as a leader in Personal Identity Products by One World Identity (OWI). OWI is a market intelligence and strategy firm focused on identity, trust, and the data economy. Each year, OWI designs an Identity Landscape, providing a comprehensive and holistic view of leaders in the identity space. As the identity industry is rapidly developing, OWI’s landscape provides an unparalleled overview of how digital identity applications are evolving and the companies and markets shaping next-generation digital identity.

With over 400 companies and 35 market segments, the 2019 Identity Landscape visually depicts a growing and maturing industry. The new, unique landscape format allows companies to touch multiple market segments, reflecting on the dynamic nature of digital identity applications. The OWI team selected 415 identity companies from a pool of over 2,000 based on several factors. 

Each company must be an identity company OR have a distinguishable line of business focused on identity.  

Each company must be at least 3 years old or have raised $3 million. 

Each company must have a functioning product in the market.  

 “Since 2017, the number of identity companies has more than quadrupled, from 500 companies to over 2,000,” said Travis Jarae, CEO and Founder of OWI. “With the wave of data breaches and privacy scandals, there is a rapid expansion of identity products and solutions. The OWI team interacts with identity companies every day, from startups to enterprise. We’re proud to share the Identity Landscape each year to distill how new companies, products, and solutions are shaping the future of identity.” 

OneRecord has been recognized as a leader in Personal Identity Products. OneRecord is a consumer data management platform comprised of two core products that enable a configurable and personalized healthcare experience. Consumers are navigating a new normal in healthcare, catalyzed by COVID 19 — one where communication and sharing with loved ones, triaging at-home, and telemedicine visits are all commonplace.  Built on best practices as defined in interoperability standards and using secured APIs, OneRecord makes it easy for individuals to take control of their healthcare. OneRecord is accessible on desktop, tablets, and mobile phones. Mobile apps for iOS and Android are available to download through the Apple App Store and Google Play.  

Digital identity is the core of digital transformation. From personal to professional applications, identity is the foundation for how we connect, engage, and interact in the digital economy. As there is increasing consumer demand for privacy and security, digital identity is no longer a nice-to-have; it is a pillar of success. The OWI Identity Landscape is a tool to help companies keep track of market growth and trends and understand the strategic importance of digital identity moving into 2020 and beyond. OWI will be releasing a more detailed research report delving into the details of each market segment and how companies within the industry overlap and intersect in upcoming months. 

OneRecord Positioned as Leader in Personal Identity Products in One World Identity’s 2019 Identity Industry Landscape 

Jennifer Blumenthal is named the chair of CommonWell Health Alliance's Privacy and Security Committee

CommonWell names OneRecord CEO chair of Privacy & Security Committee

CommonWell Health Alliance was founded in 2013 by a handful of health IT companies committed to helping solve the longstanding problem of interoperability in the healthcare industry. Traditionally competitors, these seven companies set aside their differences to focus on this simple vision.

The Alliance now has a diverse mix of member companies, ranging from health care organizations and not-for-profits to EHR companies and data exchange vendors. CommonWell members have deployed CommonWell services in all 50 states, Puerto Rico and Washington, D.C., and thousands of provider sites are utilizing these services daily.

While the vision for ubiquitous health data interoperability is simple, the solution is complex. CommonWell continues to work with its members and service providers as well as industry and government leaders to drive new innovations to make health data more accessible, with the ultimate aim of improving health outcomes.

Jennifer Blumenthal, OneRecord's Co-Founder and CEO, has been named the chair of the Privacy and Security Committee for the Alliance. As the chair, Jennifer will work alongside the other seven leadership committees to advise the Board of Directors on the direction of the Alliance.

Jennifer Blumenthal, Co-Founder, and CEO of OneRecord joins the CareQuality Steering Committee as the Chair of Consumer-Facing Technology

CareQuality welcomes OneRecord CEO into Steering Committee

This December, Carequality welcomed new members to the Steering Committee including Jennifer Blumenthal, Co-Founder and CEO of OneRecord, to the Committee as the representative for the Consumer-Facing Technology Developer.

The Steering Committee is responsible for Carequality’s strategic direction, and for the development and oversight of the Carequality Interoperability Framework. The Carequality Interoperability Framework was published in December 2015 and has since been adopted by more than a dozen leading healthcare information networks. Implementing networks have enabled more than 260,000 physicians across 850+ hospitals and 23,000 clinics.

With input from the Carequality Advisory Council and other stakeholders, the Committee manages the work of Carequality, including the adoption of new use cases and settling key decisions regarding our consensus-built Framework. 

Jennifer Blumenthal joins the CareQuality Steering Committee as the Chair of Consumer-Facing Technology

Leading the way for Patient Access: OneRecord joins the CARIN Alliance

CARIN Alliance welcomes OneRecord as a member

OneRecord is honored to join the CARIN Alliance as it's the newest member with our shared vision of advancing the ability for consumers and their authorized caregivers to easily get, use, and share their digital health information when, where, and how they want to. We look forward to working with the CARIN Alliance Board and members to change the future of healthcare.

Background
The CARIN Alliance is a non-partisan, multi-sector alliance co-founded by David Blumenthal, David Brailer, Aneesh Chopra, and Mike Leavitt. The Alliance is led by distinguished risk-bearing providers, payers, consumers, pharmaceutical companies, consumer platform companies, health IT companies, and consumer-advocates who are working collaboratively with other stakeholders in government to overcome barriers in advancing consumer-directed exchange across the U.S.

Want to learn more about the CARIN Alliance? Click here

Jennifer Blumenthal to speak on Patient Access at the Carequality Annual Meeting 2018

Carequality Annual Meeting 2018 - OneRecord CEO talks Patient Access

As patients take more ownership for their health and their health data, how are members supporting demands for consumer access to their own records? Carequality members will discuss the complexities of enabling patient access and how the Framework supports patient rights to review and contribute health information. 

Carequality - Annual Meeting 2018 - Consumers Access

Missed the meeting? Don't worry. You can watch the panel here!

Goodbye MU, Hello PI:  A new focus on patient-centered interoperability

In April 2018, The Centers for Medicare and Medicaid Services (CMS) announced that the previous EHR incentive program commonly known as “Meaningful Use” (MU) will be renamed and adapted into a program called “Promoting Interoperability” (PI). This rebranding reflects the importance that CMS has placed on electronic interoperability in healthcare.  The final rule, released by CMS on August 2, highlighted a change in measures and scoring methodology to increase the importance of patient electronic access to health information.  

Under the old Meaningful Use program, the measures were considered pass/fail on a threshold basis, requiring hospitals to meet certain thresholds to receive credit for completing a measure.  Under the new proposed rule, measures would be given a point score based on a performance ratio, meaning if the hospital performed a measure 50% of the time, they would receive 50% of that measure’s allotted points.  To be considered a meaningful user, a hospital must achieve 50 of 100 possible points.  

The points are weighted to reflect a clear emphasis on providing patients electronic access to their health information, account for 40 of the 100 points a hospital is able to earn in 2019.  CMS has stated that this measure is the crux of the PI program and the exchange of data between provider and patient is imperative in order to achieve interoperability, and thus improve health outcomes.  This flow of data creates patient-centered interoperability, as the patient acts as the hub for all their health data.

In analyzing the shift from fee-for-service to value-based purchasing in Medicare, and looking at similar performance-based payment incentive programs, such as the Hospital Readmissions Reduction Program (HRRP) and the Hospital-Acquired Conditions Reduction Program (HACRP), it can be inferred that one’s performance score for PI may become more and more crucial.  Currently, the scoring methodology for payment adjustments incurred in the Hospital Readmissions Reduction Program and the Hospital-Acquired Conditions Reduction Program is based on a comparison of how well a hospital performs against the performance of other hospitals.  Both programs use complex mathematical formulas to determine a hospital’s score, and therefore applicable payment reduction.   

The 21st Century Cures Act of 2016 mandated a new stratified scoring methodology for the Hospital Readmissions Reduction Program that evaluates hospital performance relative to other hospitals with similar proportions of patients. Under this program, hospital payments can be reduced by a maximum of 3%.   

The payment adjustment factor for the HRRP is calculated thusly:

The Hospital-Acquired Conditions Reduction Program uses a Winsorized z-score methodology that ranks hospitals on a continuous spectrum from best performing to worst performing.  Hospitals that rank in the bottom 25% of that spectrum will be subject to a 1% payment reduction.

The Windsorized z-score formula for “Hospital i” is:

These complexly calculated, comparison-based methodologies set forth by other payment incentives/penalty quality initiative programs, coupled with the fact that CMS has in the past restructured scoring methodologies as their priorities changed, lead us to infer that in the future, CMS could follow a similar approach for the PI program and adopt similar, more complexly scored comparison-based payment penalties.  

The payment adjustments for PI are in keeping with the structure that was established for MU.  No changes have been made in the penalties incurred for not being a meaningful EHR user.  As was in 2017 and 2018, the penalty for 2019 and beyond will be 75% of the percentage increase to the Inpatient Prospective Payment System (IPPS).  For example, if the increase to IPPS for a given year was 2%, a hospital that does not participate or does not meet Promoting Interoperability would only receive a 0.5% increase.  

For 2019, the Final Rule has set forth a total update percentage of 1.85% for Medicare inpatient services, making the PI penalty for 2019 1.38% (75% of 1.85).  

In 2017, inpatient payments to hospitals neared $300 billion (CMS Trustees Report 2018).  Using that figure as an estimate, hospitals are collectively at risk for losing approximately $4 billion for not meeting Promoting Interoperability.

The IPPS Final Rule requires that for the 2019 reporting year, hospitals must be using the 2015 Edition certification criteria for their certified EHR technology (CEHRT).  This requirement is in alignment with what was expected for Meaningful Use Stage 3.  According to the Office of the National Coordinator for Health IT, as of June 2018, 90% of hospitals have the 2015 Edition certified technology available from their EHR vendors.    

For Promoting Interoperability measures, CMS has stated a desire to reduce administrative burden, provide flexibility and streamline the providers’ workflow.  The overall number of required measures has been reduced from 16 to 6.  CMS Administrator Seema Verma said they are removing measures that the majority of providers are performing well on, duplicative measures, and measures that are excessively burdensome to report.  Some measures have been modified, combined, and renamed, with the goal of putting the focus of the program on health data exchange and interoperability.  

Two new measures have been adopted to address the rising opioid crisis.  For 2019 and 2020 CMS has finalized the measure Verify Opioid Treatment Agreement as an optional measure with the ability to earn 5 bonus points each year.  The measure Query of Prescription Drug Monitoring Program will be an optional measure in 2019 worth up to 5 bonus points and becomes a requirement in 2020, worth up to 5 points.

Table: The Streamlining of Measures from MU to PI

Summary of Removed and Final Measures Beginning with the EHR Reporting Period in CY 2019 

CMS has finalized a new scoring methodology for the Promoting Interoperability program.  Under the old Meaningful Use scoring methodology, measures were given a “pass/fail” once a certain threshold was attained.  The new methodology gives hospitals a performance-based score for each measure they are required to report. For example, performing a measure on 50% of all patients discharged within the 90-day reporting period will result in achieving 50% of the earnable points.   The scores are weighted to reflect the priority of the measures, so that hospitals attain more points for prioritized measures.  The point scores of the individual measures are added together to calculate the total PI score.  A total score of 50 points or more is required to satisfy Promoting Interoperability, and thus avoid a Medicare payment reduction.  Eligible hospitals must report on all required measures in order to earn any score at all.  Failure to report on any of the required measures (unless an exclusion applies), or reporting a “no” on a yes/no measure would result in a PI score of zero.  

CMS believes that the introduction of a performance-based scoring methodology will allow them to shift the emphasis from merely being a meaningful user of EHR technology to achieving interoperable, patient-centered care.   

As the measure “Provide Patients Electronic Access to Their Health Information” has been weighted the most heavily, it is now exceedingly critical that hospitals strive to meet this measure for all of their discharged patients.  In order to satisfy the measure, hospitals must: 

1. Provide patients timely access (within 36 hours of its availability to the hospital) to view, download and transmit their health information and 

2. Ensure that patient health information is available for the patient to access using any third-party application of their choice that is configured to meet the technical specifications of the application programming interfaces (API).  

CMS defines “providing access” as supplying patients with all of the necessary information needed to view, download or transmit their information.  This includes providing patients instructions on how to access their health information, a website address they can visit for online access, a unique, registered username and password, instructions on how to create a login, or any other instructions, tools or materials that patients need in order to view, download or transmit their information.  

In the proposed rule for Promoting Interoperability, CMS has highlighted the importance of APIs, stating, “API functionality supports health care providers and patient electronic access to health information.  These functions allow for patient data to move between systems and assist patients with making key decisions about their health care. … Furthermore, the API allows for third-party application usage with more flexibility and smoother workflow from various systems than what is often found in many current patient portals.” (CMS-1694-P, 1335-6)

The Provider to Patient Exchange objective promotes patient awareness and involvement in their health care through the use of APIs and ensures patients have access to their medical data.

For the first time, hospitals will be required to use CEHRT that provides API functionality, and ensure that said functionality is fully enabled to allow patients to access their health information using a third-party application.  A hospital may not block access to information or prohibit patients from using any application leveraging the API that meets the technical and security requirements. 

The measure guidance from CMS states “Eligible hospitals are expected to provide patients with detailed instructions on how to authenticate their access through the API and provide the patient with supplemental information on available applications that leverage the API.”

If a patient elects to “opt-out” of participation in the measure, the hospital may still count the patient in the numerator, if the patient is provided all the necessary information to access their health data at a later time, i.e. opt back in without further follow-up action by the hospital.  

OneRecord offers a solution to providers seeking to meet the API requirement of the Providing Patient Access measure.  We offer a patient-facing that allows users to access and aggregate their medical records across multiple providers’ EHRs, leveraging APIs.  