Endpoint Directory Services

Healthcare information is commonly available through EHR (Electronic Health Records) systems. With a provider adoption rate of over 87%, many EHR systems are also connected through health information exchange (HIE) networks. However, HIE services only provide meaningful improvement when they are available to trusted exchange partners. As with other communications infrastructure, improved connectivity, and a greater number of connections, adds value to every user.

However, there are barriers to effective use of HIE networks. According to ONC, the greatest barriers to effective health record exchange are technical lack of standards, financial cost, and trust (legal and business incentives to keep data from moving). Additional challenges are administrative and reporting requirements, and usability of IT systems.

The goal of FHIR directory services is to store information using open standards and protocols so that each of these barriers may be overcome.

In March of 2020, the Centers for Medicare and Medicaid Services released the Final Rule (“CMS Final Rule”) on Interoperability and Patient Access, requiring that CMS-regulated plans:

  • Implement and maintain openly-published HL7® FHIR® -based APIs in order to provide patients access to their health information.
  • Permits access to data by third-party applications, with approval from patient (effective Jan 1, 2021; enforceable Jul 1, 2021).
  • Support electronic exchange of data for care coordination as patients move between plans (effective and enforceable Jan 1, 2022).
  • Provide information to their members to help them protect the privacy and security of their health information including information on third party apps regarding privacy and security practices and secondary data use.

In support of this, Edifecs offers the Endpoint Directory service, a centralized directory of validated payer FHIR endpoints and third-party applications. This solution simplifies how healthcare organizations and app developers connect with each other to help consumers access and transfer their healthcare information. Endpoint Directory helps payers meet the new CMS interoperability regulations.

Endpoint Directory Benefits:

  • Allows payers to share information about endpoints, including capability statement imports. Simplifies, automates manual processes.
  • Allows payers and third-party apps to query payer endpoints for multiple use cases.
  • Validates identity of payer and third-party app participants.
  • Facilitates connection request between parties.
  • Confirms privacy and security attestations and/or privacy policy, data use agreements.
  • Ensures conformance testing and validation of FHIR endpoints and ability to work with endpoints.
  • Allows third-party apps to upload information about themselves to make available to payers.

The below Endpoint Directory solution diagram illustrates the key elements of the architecture, supporting payers, providers, and vendors with standards-based interfaces: