Tech giants Apple and Microsoft recently wrote the CMS and the Office of the National Coordinator for Health Information Technology to weigh in on their companion interoperability and information-blocking proposals, overwhelmingly voicing support for the two rules.
Apple, unsurprisingly, was enthusiastic about the agencies' effort to connect patients with their health data via third-party apps.
Apple has already taken steps toward this goal with its health records project, which is live at hundreds of hospitals and clinics and allows patients who visit participating providers to access their health data on the iPhone Health app. That integration is made possible through application programming interfaces that link the provider's EHR and the patient's iPhone.
The CMS' and ONC's long-awaited proposed rules, both released in February, outline how regulators will require insurers and providers to share medical data with patients, with an emphasis on using APIs that connect IT systems—such as electronic health records—with third-party apps.
Apple reacted positively to two controversial provisions included in the ONC's rule—capping the fees suppliers of API technology, such as EHR vendors, can charge for access to data and requiring providers to disclose price information to patients.
"We support making the maximum amount of data available to patients in order to promote price transparency and fair market competition," Apple wrote.
Microsoft also supported the proposed rules, including the ONC's proposal on restricting data-access fees. The company didn't explicitly comment on the ONC's suggestion to include price information under the broader umbrella of health data that's shared with patients.
Microsoft also encouraged the ONC to assess what privacy practices are needed when connecting patient data across multiple devices, such as the potential to use multi-factor authentication.
Unlike Apple, Microsoft doesn't have a project that connects patients with their health records via APIs, and it plans to shutter its personal health record service HealthVault in November. However, the tech giant said it sees cloud service providers like itself as playing an important role in healthcare interoperability.
"We have a long history of engaging across our customers to facilitate improved interoperability in our traditional software products and in our cloud computing services," Microsoft wrote in comments to the agencies.
Apple in its comments also highlighted its existing work maintaining the App Store, including how health apps available in the marketplace abide by the company's privacy guidelines.
"We support any action that will lead to making health information more broadly available to those who need it," the iPhone maker wrote. "Because of Apple's pioneering work on the App Store, there is now a central place for users to discover and download health and wellness apps."
However, the company has been criticized for how its platform promotes health and wellness apps. American Medical Association CEO Dr. James Madara in April referenced a blood-pressure app that had earned high user ratings in Apple's App Store, despite research that suggests it gives inaccurate results.
"I am enthusiastic about this digital future," Madara said during a panel at Modern Healthcare's Transformation Summit in April. But he added that there's still work needed to figure out how to separate high-quality health apps from "things that consumers view as health, but they're really entertainment."