21st Century Cures Act

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Kevin M. -

This is a great piece ... thanks for doing it.

Two things to point out as well:

1. Cures is not just about open notes in the patient portal in real time, it is also about patients being able to connect any app of their choice to this data in real time.

This "any app of their choice" could be the Apple Health app that is preinstalled on every iPhone (https://www.apple.com/ios/health/) or something like https://onerecord.com/ or https://mycoralhealth.com/ or https://www.medicalerrorsapp.com/

These APIs are free for patients and app developers to use (ie it is included in the cost of care)

If your hospital uses Epic, see if these apps can connect in real time by looking at https://open.epic.com/MyApps/Endpoints ... there are about 300+ systems (including Hopkins, Univ of Maryland - Dr. Mattu, some Kaisers, etc).

Epic autoenables apps for patients within 24 hours ... in fact Cures makes it illegal for them not to connect any app that wants to connect.

Also note, most developers are not healthcare providers, so HIPAA rules don't apply to them.

2. Information Blocking prohibits blocking information to healthcare systems as well.

That is, your ER can hire some web developers and create custom apps for your own EHR using the same APIs available to patients (plus more).

This could be for in house projects (like for QI projects, patient experience, etc) as well as external projects (like a research app embedded in the EHR at all participating hospitals that pulls in lab results to a central store).

Epic/Cerner/Meditech by law (Cures) has to allow health systems to connect to their own data with any app they want ... even if that app is in direct competition with Cerner/Epic/etc

Look at https://fhir.epic.com/ and https://fhir.cerner.com/millennium/r4/ to get an idea of what data is available ... it is more than stated in the podcast (meds/labs/radiology reads/etc)

I agree with the snack, this is a brave new world ... but I think smart ED's will leverage it to their advantage since information blocking enables health systems to develop and deploy any app they want with minimal effort and without special training (ie without Physician Builder at Epic or mPage training at Cerner).

Kevin Maloy MD

Gita P. -

Awesome expanded points -- thank you! Will be very interesting to see how things evolve...

Dallas H. -

Great piece, thank you!

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EM:RAP 2021 January SNACK: 21st Century Cures Act Full episode audio for MD edition 17:41 min - 20 MB - M4A