In 2025, I see a renewed focus in establishing unified networks that bridge all healthcare stakeholders, from providers, to payers, to life sciences. I refer to this as the “Veradigm Network.” This approach not only drives efficiency but ensures that care is coordinated and effective. I predict that we’ll see several important initiatives across the healthcare ecosystem to ensure a more seamless data exchange, including the use of AI to standardize data formats and strengthened bi-directional connections between providers and payers.
HI professionals sit at the forefront of pairing new AI technologies with deep patient information knowledge and expertise. They are active members and leaders of information governance teams, EHR projects, AI implementations, and financial sustainability in healthcare. For example, when a legacy HI company such as MRO Corporation announces a premier partnership with CHIME, you know an important evolution is taking place. In addition, the functionality and usefulness of CCD exchange between EHRs is really at the beginning stages.
New Hampshire State Health Information Exchange
All trying to move our healthcare system to the digital age, better outcomes, controlling and reducing costs, and patient access to their health data. The Kentucky Health Information Exchange, also known as KHIE, is a health information system that is providing interoperability between physicians, hospitals, imaging centers, and laboratories throughout the state. The KHIE system is HIPAA compliant and meets all nationally recognized standards for security and privacy. After the establishment of the Governor’s Office of Electronic Health Information, originating from an Executive Order in 2009, KHIE was initially funded through the ONC’s State Health Information Exchange Cooperative Agreement Program, a HITECH Act initative. The flexibility of the Exchange’s infrastructure makes it easy for providers, regardless of what health records system they are operating with, to engage in health information exchange and achieve Meaningful Use. Interoperability will remain a key focus in 2025, driven by both government policies and industry demand.
DirectTrust Annual Conference
They will begin building standard HL7 FHIR® APIs to exchange patients’ clinical data and conduct prior authorization transactions for roll out at the start of 2027. For these FHIR APIs to yield business value, payers and providers will also benefit by implementing AI-based tools and technology that support automated querying of independent clinical data repositories that providers and payers maintain separately. While much of the interoperability context will serve individual transactions between a single provider and payer, scalable interoperability across many provider and payer systems will be necessary to process the overall volume of transactions across the healthcare IT ecosystem. Interoperability will reach new heights in 2025, with systems integrating seamlessly to facilitate real-time data sharing across providers and care settings. AI will play a crucial role in enabling seamless communication between disparate data sources, enabling clinicians to make more informed decisions and improving patient care coordination. This enhanced connectivity will support better management of chronic diseases and transitions of care, reducing redundancies and improving outcomes.
Seven Insider Insights Heard at AHIMA24: New Energy for Coding, Data, and Exchange
Since 2007 the ONC has been operating the Nationwide Health Information Network Exchange under a department program. The program is now being transitioned to a public-private partnership to foster continued growth and create a sustainable business model. The goal is to have the transition completed by October and the new name is HealtheWay. Coding remains complex and we will always need experts to work alongside technology as it also evolves and advances. Today’s professionals make the most of that knowledge while also expanding their involvement across all information functions and technologies.
- Some senders might just send all of the patient’s clinical information in their system, resulting in an unwieldy amount of information.
- In 2025, interoperability will evolve from simply connecting systems to driving smarter, more efficient data exchange that transforms how care is delivered and accessed.
- The soon-to-be-launched integration will provide patients round-the-clock access to crucial health information through text, chatbot, or voice call.
- Since 2007 the ONC has been operating the Nationwide Health Information Network Exchange under a department program.
Alabama Health Information Exchange
C-CDA is short for Consolidated Clinical Document Architecture and is a specific type of CCD. C-CDA has been adopted as the industry standard for creating patient care summary documents. What makes C-CDA significant and an improvement on previous standards is that the data exchanged is machine-readable, so it can be picked up by HIE systems and parsed out into patient records. The C-CDA format is specified as a requirement for EHR vendors pursuing ONC certification for their products. CCD is a generic term for an electronically generated, patient-specific clinical summary document. As a result, CCDs are sometimes called a few different names – Continuity of Care Document, Summary LexaTrade Review of Care Document, Summarization of Episode Note – just to name a few.
The majority of New Hampshire hospital organizations are now submitting required public health data through NHHIO, minimizing the management of multiple connections to the State. According to research by Grand View Research, the global healthcare interoperability solutions market size was estimated at USD 3.42 billion in 2023 and is projected to grow at a compound annual growth rate (CAGR) of 14.15% from 2024 to 2030. In February 2023, the federal government provided USD 505 million to federal data partners and Canada Health Infoway to advance digital health tools and an interoperability roadmap. Thus, the rising investments and funding from government bodies are anticipated to drive the industry growth. The CORHIO HIE is one of the largest and most robust health information exchange networks in the United States, containing information for more than four million unique patients. Forty-seven hospitals, more than 2,000 doctors, 24 behavioral health centers, four large medical laboratories and the state health department are currently connected to the CORHIO HIE, with hundreds of additional health care providers and dozens of organizations in the process of connecting.
By accurately and compliantly coding the complete patient encounter—including clinical data that may not impact billing—we’re creating a new clinical asset that drives value beyond the revenue cycle. This comprehensive approach means health systems no longer need multiple coding passes and costs to support population health, medical research and clinical registries. A prior authorization is a conversation between provider and payer, which requires accurate, timely, clinical data to support the conversation.
Upcoming Events
- Continuity of Care Documents (CCDs) were developed to meet this need and their usage is being bolstered by Meaningful Use.
- The industry will prioritize not just integration but actionable insights that empower clinicians to make informed decisions and patients to confidently navigate their health journeys.
- Although FHIR is mandated, the lack of consistent implementation and the ability to customize it for specific technologies create gaps.
- FHIR is one part of the electronic prior authorization solution along with the HIPAA 278 transaction.
- Organizations that have completed the Qualified Health Information Network® (QHIN™) application and have been accepted into the project planning and testing phase of the on boarding and designation process.
And today the organizations are demonstrating actual health information exchange using the standards and policies adopted by the NwHIN. The nationwide health information network known as NwHIN is a set of standards, services and policies that enable secure health information exchange over the Internet. It is merely the foundation for how health information will be exchanged and follow a patient in our country.
It is the second connection for Georgia, which previously connected to South Carolina’s HIE. HI professionals are critical to ensuring timely, correct payments to health systems, but they must be fully engaged with other revenue cycle teams. MissionNHHIO’s mission centers on securely connecting healthcare communities to share patient health information needed for informed care decisions, and Federal and State mandatory reporting to the State’s Division of Public Health Services. Their long-term vision is to become the Granite State’s trusted resource for health information exchange and thus improve quality, efficiency and patient safety, while reducing healthcare costs. Latest NewsNHHIO reports that their membership has grown to over 65 participants, continuing their positive trend towards full financial sustainability. Over 340,000 public health transactions are being sent through the NHHIO monthly, and over 10,000 are occurring directly between providers for better patient care.
Here are some frequently asked questions on CCDs, and the C-CDA framework those documents are a part of, to help you understand them better. As we move into 2025, the focus on health data interoperability will be sharper than ever. Continued spread of value-based care models, technology-enabled innovation, and the combination of market-driven adoption with regulatory pressures are all driving the demand for seamless, high quality, interoperable data flowing across the health ecosystem. On the other hand, the Nationwide Health Information Network Exchange, which was formerly known as the NHIN Cooperative, is a group of stakeholders and integrated delivery networks that are collaborating to securely exchange health information electronically. The group includes federal agencies, local, regional and state-level Health Information Exchange Organizations (HIOs) and private organizations.
Getting high-quality data and new ways to communicate needed actions within provider workflows is essential to improve quality measures and reduce the cost of care. ContextureContexture is a nonprofit organization that provides strategic, technical and administrative support to communities committed to advancing health through information sharing. As the leading health information exchange for Arizona and Colorado, Contexture is the largest health information organization in the western region. The connection between the two states is a first for Alabama which is seeking to increase secure, real-time access to essential patient information for physicians, hospitals and other medical providers at the point of care.
The organization serves as a platform for local nonprofit health collaboratives and health information exchanges to grow and thrive. The number of participating health care users and data available in the net work grew by 111% and 118% respectively in 2014. This marks the third consecutive year of triple-digit growth rates for the organization. The soon-to-be-launched integration will provide patients round-the-clock access to crucial health information through text, chatbot, or voice call. The AI medical receptionist’s role includes arranging appointments, facilitating bill payments, and handling medication refills or referral requests. However, real human logic is still needed to be sure individual and aggregated clinical data makes sense.
Interoperability and AI Will Become More Interdependent in 2025The premise of AI in healthcare is largely centered on creating greater efficiencies and clinical decision support for care teams. In 2025, adhering to federal data-sharing standards will become increasingly important when it comes to advancing AI use cases in a highly regulated industry. While this will require greater upfront investment, secure data exchange is table stakes for patients and providers in today’s increasingly connected world. The efficacy of AI use cases, including automated documentation and predictive modeling, will be highly dependent on the quality of data feeding the models on which these processes run.