Curious About the Data at the Point of Care Pilot Program? Here Are Some Highlights

October 23, 2019

In 2018, the Trump Administration and The Centers for Medicare and Medicaid Services (CMS) launched the MyHealthE Data initiative, a program designed to put patients in control of their own healthcare data so they can make informed medical decisions.

Since the start of the program, CMS has primarily focused on sharing medical information with patients. But their new pilot program, Data at the Point of Care (DPC), intends to better connect clinicians with healthcare documentation via Health Level 7’s Fast Healthcare Interoperability Resource (FHIR®) standard and the FHIR application programming interface (API).

What is the Data at the Point of Care Pilot?

CMS Administrator, Seema Verma says The Data at the Point of Care pilot “provides Medicare claims data directly to providers to promote better patient care.”

The Data at the Point of Care pilot also gives clinicians a more thorough patient history including previous diagnoses, past procedures, and medication lists.

What does the Data at the Point of Care Pilot Hope to Achieve?

The majority of patient data resides in silos. Unfortunately, healthcare silos prevent the exchange of information and limit access to quality data. In addition, doctors are unable to access these silos directly.

Without adequate medical information, providers are left making recommendations based on incomplete medical histories, a practice that puts patients at risk. What’s more, a lack of adequate patient data increases the risk of performing duplicate tests and procedures that are costly or even unnecessary.

By giving providers access to the FHIR API, CMS hopes to improve whole person care in two specific ways:

Reduce the burden for doctors in the exam room
Give doctors more time to provide high-quality care

What Should Providers Know About the Data at the Point of Care Pilot?

The Data at the Point of Care Pilot gives providers a more comprehensive picture of their patients’ health history and overall well-being, but some challenges still exist.

For example, data sharing occurs via the Data at the Point of Care API. This API promises providers a “more robust” picture of a patients’ previous care, but it won’t provide a comprehensive health history for every individual.

In addition, providers who want to participate in the Point of Care Pilot will need to access Medicare claims data from within clinician workflows, without logging into another, separate application. This means providers must partner with vendors of electronic health record systems and find a way to connect their electronics with the Data at the Point of Care API.

How Is Patient Information Shared?

The Data at the Point of Care Pilot allows for the transfer of patient information via Medicare’s Blue Button Program and the DPC API.

Blue Button allows providers to share claims data with accountable care organizations, driving value-based care and increasing participation in new payment models. Currently, there are over 2,000 developers using synthetic data in the Blue Button 2.0 sandbox, and 28 organizations already have apps in production.

How will the DPC Pilot Improve Care Coordination and Whole Person Care?

The Data at the Point of Care Pilot hopes to improve care coordination by:

Revealing the medical history of new patients
Giving insights into a patient’s medication history and adherence
Letting providers review new diagnoses and medications
Sharing information between providers

Additionally, the program encourages the transfer of information between health organizations and social services entities. By combining efforts, providers can improve the value of care, control costs, and keep patients healthy.

Who can participate in the DPC pilot?

The DPC Pilot program launched on July 30, 2019. Providers interested in participating can apply for access here. CMS is deploying test data throughout the month of August and plans to begin production testing in September and October.

Any provider that is participating in a value-based care model or planning to transition to a value-based care model should consider applying.

By improving data sharing methods, the DPC Pilot hopes to reduce patient frustration and documentation, provide more one-on-one-time with providers, and keep a patients’ care team on the same page.