互操作性的新时代，但谁会被落下？
A New Era of Interoperability, But Who Gets Left Behind?
CMS于2025年发布了其互操作性框架，作为EMR最终实现无缝数据交换的路径。愿景很明确：通过建立一个开放、基于标准且植根于执行而非理论辩论的互联基础设施，为患者和提供者赋能。
这次的不同之处在于基调。CMS不是在发布强制要求或规则；他们提供的是一个协作蓝图，附带标准和共享基础设施。任何规模的组织都可以承诺成为CMS对齐网络（CMS-Aligned Network）。该邀请涵盖网络、EHR、支付方、提供者和数字健康应用程序。感觉所有正确的要素都已具备：更快的动力、以患者为先的思维，以及顺应行业现状的现代技术。
但尽管它被框定为自愿性的，在实践中可能并不让人觉得是自愿的。
温柔的承诺，隐藏的要求
这个承诺听起来像是一个温和的选择加入。并不要求第一天就达到所有标准，只需要承诺致力于做正确的事情。这听起来很棒。但要真正参与网络，你必须达到基本的互操作性水平。
对于十多年来一直朝着这一目标努力的组织来说，这并不令人惊讶。自Meaningful Use以来，Epic、Cerner和Athena一直有监管和经济激励来支持数据交换。他们早已达到或超过了这一互操作性水平。但在医疗保健的各个领域，情况并非如此。
如果目标是创造完整的患者体验，包括统一登录、提供者目录和无缝数据访问，那么护理生态系统的许多关键部分可能会被落下。急性期后护理、门诊康复和行为健康提供者没有得到同样的财务跑道来准备。他们现在被期望用自己的资源来达到这一标准。因此，尽管框架声称只有胡萝卜没有大棒，但对许多人来说，感觉只有大棒没有胡萝卜。
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作者：MedCity News参与缺口将扰乱患者旅程我们已经看到向院外护理的转变。医疗系统正在尽一切努力让患者远离住院环境，或让他们更快地通过这些环境。患者尽快转向康复、家庭健康和门诊护理，这些领域正在大幅增长。
但能够立即参与该框架的网络大多与我们试图弱化的住院环境相关。他们获得了资金和关注，一直是互操作性项目的明星。而医疗生态系统的其余部分并没有获得这种好处。
因此，尽管CMS的意图是正确的，并且采取了亟需的立场，但结果是不均衡的。如果你的EMR不参与，你可能不会出现在CMS提供者目录中。如果该目录在未来5到10年内成为关键工具，这将影响患者如何寻找提供者以及提供者如何做出技术决策。
即使不是官方要求，不参与的成本也会增加。也许不是今天，也许不是今年。但在未来几年内，这将产生实际的业务和运营后果。参与可能会影响转诊、可见性和网络实力。
熟悉的起点，深远的影响
这是一个熟悉的时刻。它从小处开始，然后围绕它构建系统。如果你还记得Meaningful Use，你已看到简单目标如何演变成庞大的复杂性网络。该计划变成了基于质量的护理。然后是文档交换。接着是QHIN、HIE和TEFCA。我们已经朝这个方向走了十多年。
互操作性框架是这一旅程的延续。它首先关注患者数据交换和访问。但也在为让健康保险对提供者来说更简单、并支持更多面向患者的应用程序奠定基础。对这些应用程序可能的样子已有愿景，其中可能包括摒弃剪贴板、启用对话式AI和改善慢性病管理。
其中一些优先事项非常有道理。没有人愿意每次看不同医生时都填写五次相同的表格。我们想为患者和临床医生消除这种冗余。其他优先事项则更难解读。大多数大型医疗系统已经有对话式AI解决方案。目前尚不清楚CMS是计划构建应用程序市场，还是仅仅为其他人设定标准。
无论如何，很明显这是向集中化患者访问迈出的又一步。CMS甚至表示，他们设想未来一个数字凭证就能让患者访问其在专科、初级保健和药房门户中的所有记录，而无需记住十几个用户名和密码。
提供者和技术供应商今天需要了解什么
参与的责任将落在EMR身上。但提供者需要推动其EMR优先考虑参与。这不仅仅是合规问题，而是关于患者在不久的将来会期望什么。
如果你经营一家康复治疗诊所，以下是你应该了解的：
患者可能会开始询问他们的记录在哪里。如果他们使用的是CMS对齐的应用程序，而你的EMR未连接，他们会问为什么。
患者可能会认为他们通过CMS生态系统已经给予的同意将在所有地方适用。如果你的EMR无法解释或履行这些同意，就会产生摩擦。
如果你没有列入CMS目录，这可能会影响转诊。随着时间的推移，这种可见性差距可能会影响患者流量。
这是长期运动的又一步。健康数据可移植性多年来一直是话题。这只是让我们实现目标的一种机制。CMS正在努力使其发挥作用。即使系统尚不存在，我们都应该非常接受这一想法：它即将实现，而且很快。
照片：Issarawat Tattong，Getty Images Elisabeth Brown Elisabeth Brown是WebPT的首席产品经理，领导AI与临床解决方案，WebPT是领先的康复治疗平台。
本文通过MedCity Influencers计划发布。任何人都可以通过MedCity Influencers在MedCity News上发布他们对医疗保健业务和创新的观点。点击这里了解详情。
CMS released its
Interoperability Framework in 2025 as a path forward for EMRs to finally make seamless data exchange a reality. The vision is clear: empower patients and providers by building a connected infrastructure that’s open, standards-based, and rooted in execution instead of theoretical debate.
What’s different this time is the tone. CMS isn’t issuing a mandate or a rule; they’re offering a collaborative blueprint, complete with criteria and shared infrastructure. Anyone, big or small, can take the pledge to become a CMS-Aligned Network. That invitation includes networks, EHRs, payers, providers, and digital health apps. It feels like all the right components: faster momentum, patient-first thinking, and modern technology that meets the industry where it is.
But while it’s being framed as voluntary, it may not feel voluntary in practice.
A gentle pledge with hidden requirements
The pledge sounds like a gentle opt-in. There’s no requirement to meet every standard on day one, just a commitment to work toward doing the right thing. That sounds great. But to actually participate in the network, you have to meet a baseline level of interoperability.
That’s not surprising for organizations that have been building toward this for over a decade. Epic, Cerner, and Athena have had regulatory and financial incentives to enable data exchange since Meaningful Use. They’ve already been meeting or exceeding this level of interoperability for a long time. But that hasn’t been the case across all sectors of healthcare.
If the goal is to create a complete patient experience with a unified login, provider directory, and seamless access to data, then a lot of critical parts of the care ecosystem are at risk of being left behind. Post-acute care, outpatient rehab, and behavioral health providers were not given the same financial runway to prepare. They’re now expected to meet this bar out of their own resources. So while the framework says it’s all carrot and no stick, for many, it feels like all stick and no carrot.
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Participation gaps will disrupt the patient journey We’re already seeing the shift toward care outside the hospital. Healthcare systems are doing everything they can to keep patients out of inpatient settings or move them through those settings more quickly. Patients are moving to rehab, home health, and outpatient care as quickly as possible, and those areas are seeing major growth.
But the networks that are ready to participate in this framework right out of the box are mostly organizations tied to the inpatient environment we’re trying to de-emphasize. They’ve received funding and attention. They’ve been the stars of interoperability programs. The rest of the healthcare ecosystem hasn’t had that benefit.
So even though CMS’s intent is right, and they’re taking a much-needed stance, the outcome is uneven. If your EMR doesn’t participate, you may not show up in the CMS provider directory. And if that directory becomes a critical tool over the next five to 10 years, this will influence how patients find providers and how providers make technology decisions.
Even if it’s not officially required, the cost of not participating will grow. Maybe not today, maybe not this year. But over the next few years, this will have real business and operational consequences. Participation may affect referrals, visibility, and network strength.
A familiar starting point with far-reaching implications
This is a familiar moment. It starts small. Then systems get built around it. If you remember Meaningful Use, you’ve seen how a simple goal can spiral into a massive web of complexity. That program became quality-based care. Then came document exchange. Then QHINs, HIEs, and TEFCA. We’ve been heading toward this for over a decade.
The Interoperability Framework is a continuation of that journey. It’s about patient data exchange and access first. But it’s also setting the stage to make health insurance less complicated for providers, and to support more patient-facing apps. There’s already a vision for what those apps might look like, which may include killing the clipboard, enabling conversational AI, and improving chronic disease management.
Some of those priorities make perfect sense. Nobody wants to fill out the same form five times every time they see a different doctor. We want to eliminate that redundancy for patients and for clinicians. Others are harder to unpack. Most large health systems already have conversational AI solutions. And it’s unclear whether CMS plans to build an app marketplace or just set standards for others to follow.
Either way, it’s clear this is another step toward centralizing patient access. CMS has even said they envision a future where one digital credential could let a patient access all their records across specialists, primary care, and pharmacy portals, without needing to remember a dozen usernames and passwords.
What providers and tech vendors need to understand today
The onus will be on EMRs to participate. But providers will need to push their EMRs to prioritize participation. This isn’t just about compliance. It’s about what patients are going to expect in the near future.
Here’s what you should know if you run a rehab therapy clinic:
Patients may start asking where their notes are. If they’re using a CMS-aligned app and your EMR isn’t connected, they’ll ask why.
Patients may assume consents they’ve already given through the CMS ecosystem will apply everywhere. That can create friction if your EMR can’t interpret or honor those consents.
If you’re not listed in the CMS directory, that could affect referrals. Over time, that visibility gap could impact patient flow.
This is another step in a long-term movement. Health data portability has been a topic for years. This is just another mechanism to get us there. CMS is trying to make it work. And even if the system doesn’t exist yet, we should all get very comfortable with the idea that it will and soon.
Photo: Issarawat Tattong, Getty Images Elisabeth Brown Elisabeth Brown is the Principal Product Manager leading AI & Clinical Solutions at WebPT, the leading rehab therapy platform.
This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers.
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