Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 7, 2020
Date Accepted: Nov 9, 2020
The 21st Century Cures Act, A Competitive Apps Market and the Risk of Innovation Blocking
ABSTRACT
The Office of the National Coordinator of Health Information Technology’s 2020 rule implements the 21st Century Cures Act’s required application programming interfaces to provide standardized access to all elements of a patient’s record and crisply defines practices that constitute information blocking. The rule is meant to create an ecosystem of reusable, substitutable applications that can be built once, but run anywhere in the healthcare system, “without special effort.” However, the business practices of electronic health record vendors and health care organizations in the US could still stifle innovation, and limit the size and impact of the intended health app economy. While the Cures Act and final rule are an extraordinarily significant step forward, the vision of a truly interoperable app ecosystem is not yet predetermined. Because there is ample room for “innovation blocking, measurement of progress in an open apps ecosystem and additional regulation may be needed to ensure return on the massive investment in national digital infrastructure.
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