Inovalon Consumer Health Gateway: Patient access API software

Since 1996, with the introduction of HIPAA, interoperability has often taken center stage in the healthcare arena. Today, amid new federal regulatory requirements and an unprecedented global pandemic, the importance of – and need to accelerate – the industry’s journey to achieve a truly interoperable and connected healthcare delivery system that supports better patient care and outcomes has never been clearer, especially as new requirements accelerate the need for Patient Access API software that supports the HL7® FHIR® standard.

Providers and payers have been working together for years on the most effective ways to collect and share data in healthcare interoperability collaboratives such as The Da Vinci Project, CommonWell Heath Alliance, Carequality and The Sequoia Project. However, payers have never been mandated to exchange claims and clinical data with members – that is until March of this year when CMS released its Interoperability and Patient Access final rule doing just that. By July 2021, all Medicare Advantage, Medicaid, CHIP and ACA plans must provide Patient Access and Provider Directory APIs that support the FHIR standard, as mandated in the final rule as part of the 21st Century Cures Act. By January 2022, health plans must also have in place an API in place to support Payer-to-Payer data exchange.

The path to implementing a Patient Access API

As we move further toward the end of what has been a year without compare, the next destination on our interoperability journey is clear; however, for many health plans, the path may be less so. While many health plans are still grappling with critical considerations around ensuring data accuracy, completeness and mapping to required formats; security issues related to application authentication and consumer validation; the need for deep expertise in standards-based API development, maintenance and integration aligned with the FHIR standard; patient engagement and the user experience; and much more – the clock continues to tick toward the first regulatory enforcement deadline in July.

Meet regulatory requirements with Inovalon Consumer Health Gateway

Inovalon Consumer Health Gateway™ is an API software solution designed to support the FHIR standard and help health plans address major provisions and standards requirements of the Interoperability final rule – safely, rapidly and cost-effectively.

Unlike other solutions in the market, Consumer Health Gateway is backed by more than 20 years of experience managing the nation’s most comprehensive dataset, now including more than 58 billion medical events and 324 million unique patients. With deep expertise in clinical and claims data integration and real-time clinical data exchange models that support the FHIR standard, as well as proven success delivering innovative, data-driven analytics and technologies, Inovalon delivers a streamlined solution that integrates into health plan workflows, helps support compliance with CMS data-sharing API mandates, and provides a foundation for future data-sharing and patient engagement initiatives.

Are you ready? We’ve got you covered. Learn how Inovalon can help your organization prepare for Patient Access API requirements.

Inovalon and design®, Inovalon®, and Inovalon Consumer Health Gateway™ are trademarks of Inovalon, Inc. 

HL7® and FHIR® are registered trademarks of Health Level Seven International. Use of these marks does not imply endorsement by HL7.