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Estados Unidos lanza iniciativa para impulsar la interoperabilidad de datos de salud
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La interoperabilidad de datos de salud en EE. UU ha sido históricamente uno de los principales desafíos del sistema sanitarios del país. La fragmentación tecnológica, el uso persistente de herramientas como el fax y la falta de conectividad entre plataformas, han dificultado la continuidad de la atención y el acceso eficiente a la información clínica. En este contexto, la administración Trump lanzó una nueva iniciativa con el objetivo de revolucionar el intercambio de datos de salud a nivel nacional, con respaldo del Centro de Servicios de Medicare y Medicaid (CMS).
El plan contempla dos pilares estratégicos: el Marco de Interoperabilidad de los CMS, un esquema voluntario de adopción de estándares de datos, y el fomento de herramientas digitales para la gestión de enfermedades crónicas y la navegación del sistema de salud. Según el CMS, esta alianza está diseñada para producir resultados visibles en el primer trimestre del próximo año.
Más de 60 empresas se comprometen con el marco de interoperabilidad de datos de salud en EE. UU
Uno de los aspectos más relevantes de la estrategia es la magnitud del compromiso corporativo. Más de 60 entidades incluidas empresas tecnológicas, proveedores de salud, aseguradoras y redes de intercambio de datos han decidido sumarse a la iniciativa. Entre ellas destacan Epic, Oracle Health, athenahealth, CommonWell Health Alliance, eClinicalWorks, Amazon, Google, Apple, Samsung y UnitedHealth.
En palabras del Dr. Mehmet Oz, administrador de los CMS, “durante demasiado tiempo, los pacientes de este país han soportado la carga de un sistema de salud que no ha seguido el ritmo de las innovaciones disruptivas que han transformado casi todos los demás sectores de nuestra economía”. Según el funcionario, esta alianza representa un “cambio de paradigma” a favor de pacientes y profesionales sanitarios.
¿Qué busca el Marco de Interoperabilidad de los CMS?
El marco presentado por los CMS establece criterios visionarios para los actores del ecosistema de salud digital. Entre sus principales objetivos destacan:
- Garantizar que los pacientes accedan a sus datos médicos electrónicos desde cualquier parte de la red, usando aplicaciones de su preferencia.
- Permitir el acceso a reclamos, explicaciones de beneficios y autorizaciones previas, tanto de pagadores actuales como pasados.
- Establecer tiempos de respuesta ágiles a las consultas de datos, potencialmente en tiempo real.
- Facilitar el uso de herramientas digitales por parte de los prestadores para reemplazar formularios impresos y optimizar procesos administrativos.
Relación con TEFCA y redes QHIN: convergencias aún por definir
La iniciativa convive con el Marco de Intercambio Confiable y Acuerdo Común (TEFCA), implementado a finales de 2023. TEFCA propuso un marco de gobernanza nacional para el intercambio de información, con redes calificadas como Surescripts y eClinicalWorks que han operado como QHIN (Qualified Health Information Networks).
Aunque CMS no ha explicado cómo se integrará su nuevo plan con TEFCA, 21 empresas ya han manifestado interés en convertirse en redes alineadas al marco CMS. Esto incluye a proveedores de registros electrónicos de salud (EHR) y plataformas de TI sanitaria como Epic, Oracle Health y athenahealth, así como intercambios certificados como CommonWell Health Alliance.
Sistemas de salud y tecnología: una integración progresiva
Once grandes sistemas de salud incluyendo Cleveland Clinic, Bon Secours Mercy Health e Intermountain Health se comprometieron a usar herramientas digitales para facilitar la integración de datos clínicos y eliminar el uso de portapapeles en el ingreso de pacientes. Esta acción está enfocada en reducir barreras administrativas y mejorar la experiencia del paciente.
Paralelamente, 30 empresas tecnológicas, entre ellas Google, Apple y Samsung, se sumaron a la iniciativa con compromisos específicos. Estos incluyen permitir que los pacientes accedan y compartan sus datos desde sus propias aplicaciones, así como usar estos canales para brindar apoyo clínico a personas con diabetes u obesidad.
Esta estrategia federal podría tener un impacto significativo en la atención médica al reducir duplicidades, facilitar la toma de decisiones clínicas y empoderar a los pacientes mediante el control de su información sanitaria. Además, el acceso equitativo y en tiempo real a datos clínicos es clave para reducir las brechas asistenciales entre diferentes regiones y grupos poblacionales.
A pesar de los avances técnicos logrados por iniciativas como TEFCA, la interoperabilidad en salud sigue siendo una deuda estructural del sistema. La nueva propuesta de CMS, con respaldo gubernamental y empresarial, podría marcar un punto de inflexión si logra integrarse de forma efectiva y sustentable con los esfuerzos existentes.
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