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FHIR®-Based Solution Alleviates the Need for Healthcare Organizations to Build and Maintain Their Own Patient Access API Solutions and Paves the Way for Consumers to Benefit from Their Personal Healthcare Data
BOWIE, Md., May 21, 2020 (GLOBE NEWSWIRE) -- Inovalon (INOV), a leading provider of cloud-based platforms empowering data-driven healthcare, today announced the launch of its Consumer Health Gateway™, a Fast Healthcare Interoperability Resources (FHIR®)-based solution Module of the Inovalon ONE® Platform that enables health plans with Medicare Advantage, Commercial ACA and Medicaid/CHIP insurance products to easily and efficiently comply with the new Patient Access Application Program Interface (API) requirement of the 21st Century Cures Act, effective July 1, 2021, while also paving the way for applications empowering consumers to access and benefit from their own personal healthcare data in real time.
Under the 21st Century Cures Act, organizations engaged in supporting and providing care within the United States are required to support increasing interoperability and access to patient-level data as the Centers for Medicare and Medicaid (CMS) focuses on empowering improved quality and efficiency of patient care. A key aspect of the Act pertains to supporting consumers’ access to their own patient-level data and the requirement of all health plans to support API access to the data in real time. Reflecting the technology requirements of such capabilities, on March 9, 2020, CMS released the Interoperability and Patient Access final rule (CMS-9115-F) providing insight into the costs expected to be incurred by health plans to achieve and maintain compliance, estimated to be on average approximately $2 million in the first year for health plans operating in the United States.
In addition to supporting healthcare organizations’ compliance with the Act, the mandated availability of Patient Access APIs is projected to usher in a new ecosystem of patient-focused personal healthcare apps, powered by the easily accessed, real-time availability of detailed patient-level data authorized by the individual consumer. Applications ranging from personalized diabetes management apps and mobile health coaches, to advanced healthcare organization engagement platforms and clinical trial recruitment tools, are just some of the hundreds of patient-focused consumer offerings that the patient data access marketplace is expected to empower.
“Inovalon is well positioned to serve a key role both for its health plan clients as they look to achieve compliance with the 21st Century Cures Act and for the broader healthcare marketplace as it seeks to respond to the rising forces of healthcare consumerism,” said Keith Dunleavy, M.D., Inovalon’s chief executive officer and chairman of the board. “With this offering, health plans can leverage Inovalon’s cloud platform, existing data connectivity, and large-scale longitudinal data assets, to cost-effectively deliver a compliant, secure solution, and concurrently the offering helps empower consumers to benefit from authorized applications leveraging their personal data.”
As part of its Inovalon ONE® Platform, Inovalon maintains one of the nation’s largest networks of healthcare data connectivity and the nation’s largest primary-source healthcare dataset containing deep, longitudinally matched data pertaining to more than 315 million patients and 55 billion medical events, empowering a significant breadth of the U.S. health plan marketplace, including 24 of the nation’s largest 25 health plans. Through a FHIR®-enabled, real-time clinical data exchange, patient authentication toolsets, and easy to configure interfaces, clients can readily leverage their existing engagement of the Inovalon ONE® Platform with Inovalon’s Consumer Health Gateway Module to cost effectively achieve compliance with the 21st Century Cures Act. The combination also enables the delivery of highly personalized consumer-facing offerings to further engage their membership base and differentiate their organizations within the marketplace.
Inovalon’s Consumer Health Gateway™ is a consumer portal allowing the FHIR®-based exchange of an individual patient’s claims and clinical data securely and seamlessly with authorized third-party applications. Powered by a robust patient consent and authentication platform, Inovalon’s Consumer Health Gateway™ provides an industry-leading capability to authenticate any third-party app the consumer is using to access their healthcare data, as well as authentication of the consumer themselves to prevent fraud.
The capability set delivers a seamless approach to compiling and validating the comprehensive set of the respective patient’s clinical information (inclusive of all elements of the United States Core Data for Interoperability (USCDI)) and claims data (inclusive of all components of the Common Payer Consumer Data Set (CPCDS)) and providing such information back in real time through FHIR® 4.0 Resources in accordance with the specifications of the Interoperability Rule.
APIs such as Inovalon’s Consumer Health Gateway™ are just one of the capabilities offered through Inovalon’s Healthcare Data Lake, which delivers user-friendly dashboards, exportable data extracts, and advanced query tools to support advanced analytics initiatives and help healthcare organizations solve complex business and clinical issues. Inovalon’s Healthcare Data Lake plays an integral role in helping health plans align and comply with the Patient Access API requirement and the broader Interoperability Rule. It provides a comprehensive data and analytics ecosystem complemented by extensive data connectivity and reach to more than 700,000 provider EHRs, and expanded access into new data sources including CMS’ Blue Button 2.0.
Inovalon is a leading provider of cloud-based platforms empowering data-driven healthcare. Through the Inovalon ONE® Platform, Inovalon brings to the marketplace a national-scale capability to interconnect with the healthcare ecosystem, aggregate and analyze data in real time, and empower the application of resulting insights to drive meaningful impact at the point of care. Leveraging its Platform, unparalleled proprietary datasets, and industry-leading subject matter expertise, Inovalon enables better care, efficiency, and financial performance across the healthcare ecosystem. From health plans and provider organizations, to pharmaceutical, medical device, and diagnostics companies, Inovalon’s unique achievement of value is delivered through the effective progression of “Turning Data into Insight, and Insight into Action®”. Supporting thousands of clients, including 24 of the top 25 U.S. health plans, 22 of the top 25 global pharma companies, 19 of the top 25 U.S. healthcare provider systems, and many of the leading pharmacy organizations, device manufacturers, and other healthcare industry constituents, Inovalon’s technology platforms and analytics are informed by data pertaining to more than 994,000 physicians, 558,000 clinical facilities, 315 million Americans, and 55 billion medical events. For more information, visit www.inovalon.com.
Kim E. Collins
Senior Vice President, Corporate Marketing & Communications
Vice President, Investor Relations