Some of you may have noticed that your connections require attention even after following the instructions for troubleshooting. To understand why some accounts are experiencing these issues, I’d like to tell you about healthcare data and the fight for patient access. In this article, I’ll discuss the 21 Century Cures Act, information blocking and interoperability concepts, and how all this may contribute to issues connecting your health records on Kindred. 

21st Century Cures Act 

On December 13th, 2016, the 21st Century Cures Act (Cures Act), which aims to accelerate disease research and streamline the development of drugs and medical devices, was signed into law. It passed the House and Senate with overwhelming support from both sides.  

One big provision of the legislation relates to interoperability and information blocking. Interoperability essentially refers to the ability of various computer software to exchange information, like how Kindred can store your medical data through your Electronic Health Record (EHR). More specifically, Title IV of the Cures Act states that health information technology developers or entities may not “take any action that constitutes information blocking” and provide an application programming interface (API) for easy data transfer.  

An API is how different software communicate with each other. There are a couple of key terms related to using an API:  

• Client: the user, website, or software making the request.  
• Request: a digital request asking for different resources from the server.  
• Response: a digital response containing the resources requested from the server.  
• Server: the behind-the-scenes software that processes the request and gets the appropriate response.  

The easiest way to describe what an API does is to imagine you’re at a restaurant and the waiter comes to get your order. The waiter writes your order down on paper and then hands it to the kitchen. The kitchen staff prepares the meal and gives it to the waiter, who brings it back to you.  

In this hypothetical scenario, you’re the client, your order is the request, the waiter is the API, the response is your order, and the kitchen is the server. The API is responsible for getting the request where it needs to go and returning the appropriate response.  

When the Cures Act was signed, the Office of the National Coordinator for Health Information Technology (ONC) developed a list of “medical resources” they deemed integral to advancing interoperability. The United States Core Data for Interoperability (USCDI) list was released in July 2020 to line up with the Fast Healthcare Interoperability Resources (HL7® FHIR) guide for implementing medical APIs.  

What's Fast Healthcare Interoperability Resources? 

FHIR essentially refers to the information your healthcare providers are required to share. The list includes medical data like:  

• healthcare team 
• medications 
• vitals 

There are additional standards for a developer to implement a server or make a request. Still, essentially FHIR allows developers at Kindred to write code once and have it work with multiple EHRs. 

How does the Cures Act and FHIR affect my broken connections? 

Fast forward a few years, and the world is devastated by the COVID-19 pandemic. Hospital systems are overwhelmed, and the ONC extends certain deadlines of the Cures Act to help ease the burden— including compliance with information blocking policies to April 5, 2021.   

The ONC also moved the final day for healthcare information technology (IT) developers to implement their FHIR APIs to December 31st, 2022. This date is rapidly approaching, and some larger EHR companies have already gotten their APIs live, like Epic, Cerner, and Veterans Affairs facilities.  

The gist  

At Kindred, we value the intention of the Cures Act and believe that secure data sharing can help to accelerate research and improve patient outcomes. FHIR APIs are a more reliable way of gathering your data. Kindred wants to be an early adapter, but there are details to iron out. We’re working closely with EHR teams and insurance providers to transition as smoothly as possible, but there will likely be some kinks along the way.   

We know things aren’t currently working as expected, so keep an eye on your notifications (the bell icon on the top right corner of the Kindred screen). We’ll let you know when everything is working as expected and what to do if your connections need some help.  

On behalf of everyone here at Kindred, we want to thank you for helping us pioneer a path to revolutionizing healthcare and research. You’re at the front of an important part of history. We can’t achieve our goals without the support of each of our users. 

If you have questions about data connection on Kindred, contact Kindred's Content and Community Manager at Talia@Hugo.Health. She'll gather community questions to create a guide that clarifies the subject.