ONC Supports Adoption and Implementation of Bulk Data APIs

By Alex Kontur, ONC
Twitter: @ONC_HealthIT

In 2017 the Health Level Seven® (HL7) standards development community began exploring the feasibility of standardizing a Fast Healthcare Interoperability Resources® (FHIR) bulk data access application programming interface (API) to facilitate large-scale data transfer between systems.

At a December 2017 meeting hosted by the SMART® Health IT project at Boston Children’s Hospital (BCH), stakeholders agreed that such an API was both achievable and worth pursuing. In 2019 the HL7 community balloted and published the first version of the Bulk Data Access FHIR Implementation Guide (Bulk Data IG), which included operations for querying data from all or a group of patients, a more efficient file format for streaming data, and capabilities for asynchronous requests to kick-off a bulk data export.

ONC’s Cures Act Final Rule added a new certification criterion to the ONC Health IT Certification Program at §170.315(g)(10) for standardized APIs for patient and population services. ONC also adopted a suite of regulatory provisions that address health IT developers’ business practices associated with certified API technology through the API Condition of Certification. Health IT developers seeking certification to this criterion are required to implement an API using the HL7 FHIR standard to make patient data available to users. The criterion also requires developers to build capabilities for standardized export of large quantities of health information according to the Bulk Data IG. Adoption of “bulk data” APIs by certified health IT products represents the culmination of more than five years of work to enable more efficient access to large sets of health data.

To support implementers, ONC funded the SMART team under a cooperative agreement with HL7 to develop the following open-source tools:

  • Bulk Data Server – A configurable reference implementation of a bulk data server conforming to the Bulk Data IG.
  • Bulk Data Client – A sample client application using a command-line interface to test bulk data servers.
  • Bulk Data Test Suite – A web-based online tester for bulk data servers that contains a test suite and test runner. The test suite has been integrated into the Inferno test tool.
  • Bulk Data Tools – A library for working with and converting bulk data into different formats.

As of today, the Bulk Data IG has been through multiple rounds of community testing and feedback, including a second version released in 2021. Implementations of bulk data are already underway, including several commercial products in the ONC Health IT Certification Program. The Centers for Medicare & Medicaid Services has also implemented the Bulk Data IG to deliver large sets of Medicare Fee-For-Service claims data under the Data at the Point of Care pilot project and Beneficiary Claims Data API (BCDA).

ONC is excited about the possibilities bulk data can unlock and encourages developers to make use of the open-source tools developed by BCH to design, build, and test a new generation of applications and services using bulk data. For more information about the new API certification criterion and the API Condition of Certification, please check out the ONC Health IT Certification Program’s resources page.

This article was originally published on the Health IT Buzz and is syndicated here with permission.