Category: API

Interoperability is a big discussion in health care, with
new regulations requiring interoperability for patient data. Most approaches
follow the typical RESTful API approach that has become the standard method for
data exchange. Yet Health Level Seven (HL7), with its new Fast Healthcare Interoperability
Resources (FHIR) standard for the electronic transfer of health data, is
leading to a rash of implementations that, to date, are not solving core interoperability
issues. 

Data is still insecure, users can’t govern their own health
records, and the need for multiple APIs for different participants with
different rights (human and machine) in the network is adding unneeded
expenditures to an already burdened healthcare system. The way out is not to
add more middleware, but to upgrade the basic tools of interoperability in a
way that finally brings healthcare
technology into the 21st century.  

A Timely Policy 

Doctors, hospitals, pharmacists, insurance providers,
outpatient treatment centers, labs and billing companies are just a few of the
parties that comprise the overcomplicated U.S. healthcare system. 

In digitizing medical files, as required by the 2009 Health
Information Technology for Economic and Clinical Health (HITECH) Act, providers
have adopted whatever solution was most convenient. This has led to the mess of
interoperability
issues that HL7 seeks to remedy with FHIR. 

Existing Electronic Medical Records
(EMR) systems do not easily share data. Best case, patients have to sign
off to share data with two incompatible systems. Worst case, information must
be turned into a physical CD or document to follow the patient between
providers. Data security is also notoriously poor. Hackers prioritized the healthcare sector as their main target in 2019; breach
costs exceeded $17.7 billion.

The New Infrastructure Rush

When common formats, by way of FHIR and HL7, provided
standards and solutions to empower global health data interoperability, the
industry erupted into a flurry of activity. Thousands of healthcare databases
are now being draped in virtual construction tarps and surrounded by digital
scaffolding. 

Building a new, interoperable data ontology for the entire
healthcare system is a massive undertaking. For one, 80% of hospital data is
managed using the cryptic, machine-language HL7 Version 2. Most of the rest
uses the inefficient, dated XML data format. HL7 FHIR promotes the use of more
modern data syntaxes, like JSON and RDF (Turtle). 

Secondly, databases have no notion of the new FHIR schema.
Armies of developers must build frameworks and middleware to facilitate interoperability.
This is why Big Tech incumbents including Google Cloud Healthcare, Amazon AWS
and Microsoft for Healthcare are jumping into the fray with their own
solutions. 

The outcome, once HL7’s 22 resources are fully normative, will
be seamless information sharing, electronic notifications, and collaboration
between every player in the giant web of patients, providers, labs, and
middlemen. But it will come at a steep cost in the current traditionally RESTful
API-based manner that is being broadly pursued. 

The Problem with APIs

The new scaffolding is expensive, takes data control away
from patients, and is not inherently secure. The number of unique APIs required
to support the access, rights and disparate user base in the healthcare network
are the reason. 

Interoperability requires a common syntax and “language” to
enable databases to talk to each other. The average traditional API costs up to
$30,000 to build, plus half that cost to manage annually. That is not to
mention the cost to integrate and secure each API. A small healthcare
organization with only 10 APIs faces costs of $450,000 annually for basic API
services. 

When you consider that most big healthcare organizations will
need to connect thousands of APIs, HL7’s interoperability schema really is the
best way forward. The traditional API tooling to manage the interoperability of
the well-framed data structures, however, is the problem. 

Moreover, the patient, the rightful owner of their own
health record, still doesn’t have the ability to govern their own data. Because
change only happens in the database itself, the manager of the database, not
the patient, controls the data within. 

In the best case, this puts an additional burden on patients
to give explicit permission every time health records move between providers.
In the worst case, a provider sees an entire medical history without a
patient’s consent–your podiatrist seeing your psychiatric records, for
example.

Finally, each API enables one data store to talk to the
next, opening opportunities for bad actors to make changes to databases from
the outside. The firewalls that protect databases and networks are penetrable,
and user profiles are sometimes created outside of the database itself, making
it possible to expose, steal and change data from outside the database. 

In that light, HL7 is paving the wrong road with good
intentions. But there is another way. 

Semantic Standards and Blockchain to the Rescue

If you eliminate data APIs, secure interoperability, with
data governance fully in the hands of the patient, becomes possible. Healthcare
data silos will be replaced with a dynamic, trusted and shared data network
with privacy and security directly baked in. The solution involves adding
semantic standards for full interoperability, blockchain for data governance
and data-centric security. 

Semantic standards, such as RDF formatting and SPARQL
queries, let users quickly and easily gain answers from multiple databases and
other data stores at once. Relational databases, the ones currently in use in healthcare,
are all formatted differently, and need API middleware to talk to one another.
Accurate answers are not guaranteed. Semantic standards, on the other hand,
create a common language between all databases. Instead of untangling the
mismatched definitions and formatting inevitable with relational databases,
doctors’ offices, for example, could easily pull in pertinent patient records,
insurance coverage, and the latest research on diseases.

Patients, for their part, would use blockchain to regain control
of their data. Patients would be able to turn on aspects of their data to
specific caregivers, instead of relinquishing control to database business
managers, as is currently the case. Your podiatrist, in other words, will not
be able to see your psychiatric records unless you choose to share them. 

The data ledger, which lives on the blockchain, will contain
instructions as to who can update (writer new records on) the ledger, who can
read it, and who can make changes. All changes are controlled by private-key
encryption that is in the hands of the patient; only those with authorization
can see select histories of health data (or, as in the case of an ER doctor,
entire histories, with permission). 

Data security is controlled in the data layer itself,
instead of through middleware such as a firewall. Data can be shared without
API, thanks to those semantic standards, and data are natively embedded with
security in the blockchain. Compliance, governance, security and data
management all become easier. Data cannot be stolen or manipulated by an
outside party, the way it commonly is by healthcare hackers today. 

The interoperability conundrum, in other words, is solved.
Fewer APIs means fewer security vulnerabilities; a common, semantic standard
eliminates confusion and minimizes mistakes. Blockchain puts patients in
control of who sees what parts of their health records. Eliminating the need
for API middleware also saves tens of thousands of dollars, at a minimum.

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About Brian Platz 

Brian is the Co-CEO and Co-Chairman of Fluree, PBC, a decentralized app platform that aims to remodel how business applications are built. Before establishing Fluree, Brian was the co-founder of SilkRoad technology which expanded to over 2,000 customers and 500 employees in 12 international offices.

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Healthcare data security has been a growing concern for CIOs for the last year or so, as hackers are increasingly targeting health information. Now, with a global pandemic forcing a shift to telemedicine and remote work, and new rules from the ONC and CMS introducing more regulatory burden, healthcare CIOs have more to manage than ever. Fortunately, it is possible to roll out new capabilities while simultaneously improving cybersecurity by following these three rules:

Rule 1: Think Like an Attacker

The coronavirus pandemic has forced healthcare providers everywhere to roll out new capabilities, processes, and workflows, such as telemedicine systems and new patient check-in procedures. These measures are being taken in addition to the necessary work being done to comply with the new mandates from ONC and CMS regarding patient data accessibility. Though these changes need to be implemented quickly, it’s important to follow cybersecurity best practices to avoid providing new openings for attackers. 

When a hacker sees new systems and processes being implemented, they are thinking about:

– What software is being introduced? Are there known vulnerabilities or frequently unpatched exploits associated with it?

– How are new endpoints being added and are they secure?

– Since the new ONC and CMS rules require publicly exposed FHIR APIs, how can those be attacked? Are there social engineering exploits that can provide a way around security?

– Are there ways to perpetrate identity fraud if a patient does not need to be physically present to receive healthcare?

This approach should lead to a cybersecurity plan that puts measures in place for each identified risk. By thinking like the adversary, it is possible to identify and lock down the possible attack vectors. 

Rule 2: Minimize the Attack Surface

Every way into an organization’s network needs to be secured, monitored, and maintained. The best way to make this process as efficient and fool-proof as possible is to minimize the number of ways into the network. 

This is especially difficult in light of the ONC and CMS rules, which require that clinical systems must share data through publicly available FHIR APIs. At first, this seems like a mandate to radically expand the organization’s attack surface. Indeed, this is precisely what happens if the straightforward approach of exposing every clinical system through public APIs is followed. 

A different approach, which provides the same capabilities and compliance with the rules, would be to route all API traffic through a central hub. Attaching all the clinical systems to a single point of API access provides a number of benefits:

– Most importantly, compliance is achieved while minimizing the new attack vectors.

– All traffic between clinical systems and the outside world can be monitored from a single place.

– The API hub can act as a façade that makes legacy systems compliant with the new rules, even if those systems lack native FHIR API capabilities.

The API hub need not be an expensive new component of the network architecture. Most healthcare organizations are already using a clinical integration engine to move HL7, XML, and DICOM traffic among their internal systems. The same technology can serve as an API hub. This is especially effective if a new instance of the integration engine is placed in an isolated part of the network without full access to other systems. 

Rule 3: Have an Expert Review the Defenses

Even for healthcare organizations with cybersecurity experts on staff, it can be worthwhile to bring in a cybersecurity consultant to cross-check new implementations. Novel threats are constantly shifting and emerging, making it nearly impossible for internal IT staff to keep up with the looming threats of ransomware hacks, while also adequately carrying out the day-to-day responsibilities of their jobs. For that reason, it makes sense to bring in a professional who focuses exclusively on security. It is also often useful to have an independent review from someone who is looking at the implementation from an outsider’s perspective. Independent consultants can provide the necessary guidance, risk assessments, and other security support, to set healthcare organizations up for success and operate more securely. 

Expanding an organization’s IT capabilities often means more exposure to risk, especially when implementations are subject to time constraints. However, given the value and importance of the data that’s being generated, transmitted, and stored, it is imperative not to let cybersecurity fall out of focus. By following best practices around design, implementation, and testing healthcare organizations can rise to meet the current challenges of the pandemic, address the mandates of the interoperability rules, and simultaneously improve data security measures. 

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About Scott Galbari, Chief Technology Officer

As Chief Technology Officer for Lyniate, Scott leads the development and delivery of all products and services. Scott has been in the healthcare IT domain for the past twenty years and has experience in developing and delivering imaging, workflow, nursing, interoperability, and patient flow solutions to customers in all geographies. He was most recently the General Manager for multiple businesses within McKesson and Change Healthcare and started his career as a software developer.

About Drew Ivan, Chief Product & Strategy Officer

Drew’s focus is on how to operationalize and productize integration technologies, patterns, and best practices. His experience includes over 20 years in health IT, working with a wide spectrum of customers, including public HIEs, IDNs, payers, life sciences companies, and software vendors, with the goal of improving outcomes and reducing costs by aggregating and analyzing clinical, claims, and cost data.

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An API-first approach supports low-code solutions, and that is of immense value to healthcare facilities right now.

A recent BBC article discusses the rise in employee health
tracking via wearable devices and highlights a number of concerns around data
privacy. To try and prevent health tracking schemes from crossing ethical
lines, and eroding trust between employee and employer, some industry figures
believe that organizations need to work with third-party vendors who specialize
in managing wellbeing data. These vendors would hold the data independently
under strict privacy rules, and work with employees directly to change their
lifestyles.

We recently spoke with Pop, Founder, and CEO of Human API to understand how a user-controlled data platform can address privacy concerns surrounding employee wellness programs. Human API delivers a user-controlled health data ecosystem that gives users full control of which enterprises, insurers, and researchers they want to share their data with to learn more about. The company works alongside a number of organizations such as Omada Health and Thrive Global helping them create wellness programs for their employees while keeping their personal data secure.

HITC: In response to the COVID-19 pandemic, how are
employers investing in employee wellness?

Pop: We have seen a number of different initiatives
across the board. Some of the more obvious include offering access to
mindfulness tools, online workouts, fitness apps, or online counseling services
for key issues such as mental health, financial distress, or relationship
difficulties. Others are more inventive, such as tools that encourage employees
to take breaks or ensure they are working in a safe environment at home.

We believe that one of the most important lessons and
reminders for employers during COVID-19 is that employees are the most valuable
assets for any business. Companies that treat their employees as such and
invest in making their teams feel supported throughout the crisis will thrive
in the long run. 

After all, recent studies show that 80% of employees at companies with
developed health and wellness programs feel engaged in their workplace and cared
for by their employers. Modern employees — especially Millennials — are
motivated to join businesses that are committed to their improvement and
progression. While one year ago, this may have meant salary increases and
promotions, through the lens of COVID-19 this also means improving employees’
health and well-being.

Our customers like Thrive Global are actively working with
their employer customers to build additional well-being programs and products
on top of their software platform, to support employee resilience, well-being,
and productivity.

This recognition that healthier, happier employees are proven to be more
creative, productive, and less transient, is driving this increased interest in
wellness initiatives. We believe it will continue to do so well after a vaccine
has solved the immediate threat from COVID-19. Employee well-being is going to
be table stakes in the future for employers who want to attract and retain the
best talent. 

HITC: Has the remote workforce revolution increased
interest in these programs from employers?

Pop: We think about this question a lot since we’re a
virtual-first company by design. Remote working is a trend that has been
accelerated by years due to the pandemic, and our customers are actively
building new wellness solutions to empower employers to take better care of
their people. Wearable devices are now front and center as a way to support
employee wellness, and programs are rapidly emerging to help people stay active
and healthy during these trying times.

Increased interest in wellness solutions to problems
associated with ‘stay at home’ measures — such as a strain on mental health —
is clearly represented in funding data from 2020. A recent report from CB Insights shows that
although wellness applications for general fitness and sleep saw fewer deals
and dollars than they did in the first half of 2019, there has been a spike in
funding for mental health-focused wellness startups. 

During the pandemic, which has been described as a ‘mental
health crisis,’ downloads of consumer meditation and mindfulness apps like Calm
and Headspace have increased significantly. 

We’re also seeing a lot of movement in the enterprise space.
A couple of examples include Spring Health, a service that helps companies
offer their workers mental health benefits, which recently raised $76 million, and MindLabs,
which recently raised $1.8M for its mobile app combining live videos from
mental health professionals leading meditation and mindfulness sessions, with
an EEG headband that measures heart and respiration rates to show how
successful sessions are in reducing stress. 

HITC: What role will user-controlled data platforms play
in working with these enterprises?

Pop: User-controlled data platforms will facilitate
the secure transaction and exchange of fragmented health data to power wellness
solutions, programs, and products, and ultimately accelerate the pace of
innovation for enterprises. Platforms like ours have a vested interest in
earning and keeping user trust, and are able to offer an extra layer of
security and privacy (peace of mind) to end-users. We believe our approach to
enabling data sharing will continue to increase adoption and user participation
in wellness programs and solutions. As we’ve seen in other industries,
companies Uber, and other modern transaction layers that enable trusted
transactions opened the market to new innovations and new consumer behaviors.
Our platform is helping drive enterprise and consumer behavior in a similar way
by accelerating the rise of a consumer health ecosystem that empowers people to
be proactive participants in their own health and well-being. 

HITC: How can employees control their data to solve the
trust issue?

Pop: Through our platform, employees can connect and
disconnect a data source any time they want. They are in full control of which
companies have access to their health data, and we’ll never sell any
identifiable employee health data. Our security policy and protocols are designed
in the best interest of employees (end consumers) to maximize trust,
engagement, and participation. 

HITC: What challenges and trends do you see heading into
2021 and beyond for the user-controlled health data ecosystem?

Pop: Trust remains a big issue, but we find that
people are beginning to be more comfortable with sharing their data while
they’re at home. I believe the biggest challenge to the rise of a new consumer
health ecosystem is how fast industries and enterprises can adapt and innovate.
This is new terrain that companies are learning to navigate and master. We’re
seeing the emergence of a new wellness paradigm to respond to the pandemic, and
we’re excited to help accelerate the trend of empowering consumers to take
control of their own health. As more health data sources come online, our
consumer health data platform will help enable more innovative products and
solutions. There’s a global opportunity and historic moment here to capitalize
on by leveraging the power of wearable technology and health data to transform
consumer well-being.

What You Should Know:

– Highmark Health signs six-year strategic partnership agreement
with Google Cloud to transform the health experience for patients and
caregivers through the development of Highmark Health’s new Living Health
Model

– The Living Health model is designed to eliminate
the fragmentation in health care by re-engineering the healthcare delivery
model with a more coordinated, personalized, technology-enabled experience.

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Highmark Health and Google Cloud today announced a six-year strategic partnership to build and maintain the innovation engine behind Highmark’s Living Health model. The agreement includes the development of the Living Health Dynamic Platform, which will be designed to help overcome the complexities and fragmentation within the healthcare industry.

Re-engineering The Healthcare Delivery Model

Highmark’s Living Health model is designed to eliminate the fragmentation in health care by re-engineering the healthcare delivery model with a more coordinated, personalized, technology-enabled experience. In addition to offering seamless, simpler, and smarter interactions with patients, the Living Health model is designed to free clinicians from time-consuming administrative tasks while providing them with timely data and actionable information about each patient. Living Health is not just focused on improving the patient-clinician relationship, it is about changing the way health care delivery operates.

“The Living Health model is about improving each person’s health and quality of life, every day,” commented Dr. Tony Farah, executive vice president and chief medical and clinical transformation officer of Highmark Health. “The traditional health care system is too fragmented and for the most part reactive. The Living Health model takes the information and preferences that a person provides us, applies the analytics developed with Google Cloud, and creates a proactive, dynamic, and readily accessible health plan and support team that fits an individual’s unique needs.”

Living Health Model
Powered by Google Cloud

Highmark Health will lead the collaboration to build its
Living Health Dynamic Platform on Google Cloud. Key elements of the agreement
include:

– The construction of a highly secure and scalable platform
built on Google Cloud

– The application of Google Cloud’s advanced analytic and
artificial intelligence capabilities to supercharge Highmark Health’s existing
clinical and technology capabilities

– The engagement of a highly skilled professional services
team that will collaborate to drive rapid innovation

– The use of Google Cloud’s healthcare-specific solutions, including the Google Cloud Healthcare API, to enable rapid innovation, interoperability, and a seamless Living Health experience.

Highmark Health will control access and use of its patient
data using rigorous long-standing organizational privacy controls and
governance, which will be enhanced through the creation of a joint Highmark
Health-Google Cloud Data Ethics and Privacy Review Board to ensure that uses of
data are consistent with prescribed ethical principles, guidance, and customer
expectations of privacy.

Why It Matters

The strategic partnership reflects Highmark Health’s vision for a remarkable health experience by moving care and disease management of clinical conditions beyond traditional care settings through an engaging digital experience. By providing the insights needed to enable timely interventions, people will be empowered to proactively manage their health. For example, specific outcomes could include proactive intervention based on timely and individual patient data; digital disease management; easily accessible, personalized health plans; and centralized scheduling and management of care teams.

Economic Impact of Partnership

Approximately 125 new jobs are being created at Highmark Health to support the development of the Living Health Dynamic Platform, specifically in the areas of application development, cloud-based computing architectures, analytics, and user experience design.  

When 2020 began, no one anticipated that complying with the Merit-based Incentive Payment System (MIPS)—the flagship payment model of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)—would look so different halfway through the year. Like many other things, the COVID-19 crisis has delayed, diverted, or derailed many organizations’ reporting efforts and capabilities. Lower procedure volumes, new remote work scenarios, and shifting priorities have taken attention away from MIPS work. 

Despite the disruptions and uncertainties associated with the pandemic, healthcare organizations should not lose track of MIPS compliance and the program’s intent to improve care quality, reduce costs, and facilitate interoperability. Here are a few strategies for keeping a MIPS program top of mind. 

Understand the immediate effects of the pandemic on MIPS reporting 

Due to COVID-19, CMS granted several 2019 data reporting exceptions and extensions to clinicians and providers participating in Medicare quality reporting programs. These concessions were enacted to let providers focus 100% of their resources on caring for and ensuring the health and safety of patients and staff during the early weeks of the crisis. For the 2020 MIPS performance period, CMS has also chosen to use the Extreme and Uncontrollable Circumstances policy to allow requests to reweight any or all of the MIPS performance categories to 0%.

Clinicians and groups can complete the application any time before the end of this performance year. If practices are granted reweighting one or more categories but submit data during the attestation period, the reweighting will be void and the practice will receive the score earned in the categories for which they submit data

Seize the opportunity to improve interoperability 

Interoperability is a key area that organizations were focused on before the crisis, and this work still warrants attention. If an organization is not on the front lines of the COVID-19 response, it should use this time to shore up communications with other entities so, once things return to “normal,” it will be well prepared to seamlessly exchange information with peer organizations. 

Establishing processes for sending and receiving care summaries via direct messaging is important for practices to earn a high score in the Promoting Interoperability category. Direct messaging is a HIPAA-compliant method for securely exchanging health information between providers, which functions as an email but is much more secure due to encryption. A regular pain point organizations face is being unable to obtain direct messaging addresses from peer organizations, including referral partners.

To assist providers in this area, the Office of the National Coordinator for Health Information Technology (ONC) and CMS has created a mandatory centralized directory of provider electronic data exchange addresses published by the National Plan & Provider Enumeration System (NPPES). The NPPES directory is searchable through a public API and allows providers to look up the direct messaging addresses for other providers. To meet current interoperability requirements, providers must have entered their direct messaging address into the system by June 30, 2020. If they haven’t done so, the provider could be publicly reported for failure to comply with the requirement, which could constitute information blocking. 

Take time now to ensure direct messaging addresses have been entered correctly for all members of your practice. This is also a good time to begin reaching out to top referral sources to make sure they are also prepared to send and receive information.

Look for ways to streamline quality reporting 

Over the next few months, the focus will return to quality measure reporting. As such, it’s wise to take advantage of this time to ensure solid documentation and reporting methods. Electronic medical records (EMRs) can be helpful in streamlining these efforts.

For example, dropdown menus with frequently used descriptions and automated coding can enable greater accuracy and specificity while easing the documentation process for providers. Customizable screens that can be configured to include specialty-specific choices based on patient history and problem list can also smooth documentation and coding, especially if screen layouts mirror favored workflow.

Regarding MIPS compliance in particular, it can be helpful to use tools that offer predictive charting. This feature determines whether a patient qualifies for preselected MIPS measures in real-time and presents the provider with data fields related to those items during the patient encounter—allowing the physician to collect the appropriate information without adding additional charting time later on. 

With respect to reporting, providers may benefit from using their certified EMR in addition to reporting through a registry. At the beginning of the MIPS program, providers could report through both a registry and EMR directly and would be scored separately for their quality category through each method. They would then be awarded the higher score of the two. This method had the potential to leave some high-scoring measures on the table.

Beginning in 2019, providers reporting through both registry and EMR direct are scored across the two methods. CMS uses the six highest scoring measures between the two reporting sets to calculate the provider’s or group’s quality score, potentially resulting in a higher score than the provider would earn by reporting through either method alone. 

A knowledgeable partner can pave the way to better performance

COVID-19 has impacted healthcare like no other event in recent history, and it’s not surprising that MIPS compliance has taken a back seat to more pressing concerns. However, providers still have the opportunity to make meaningful progress in this area. By working with a technology partner that keeps up with the current requirements and offers strategies and solutions for optimizing data collection and reporting, a provider can realize solid MIPS performance during and beyond this unprecedented time.

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About Courtney Tesvich, VP of Regulatory at Nextech

Courtney is a Registered Nurse with more than 20 years in the healthcare field, 15 of which have been focused on quality improvements and regulatory compliance. As VP of Regulatory at Nextech, Courtney is responsible for ensuring that Nextech’s products meet government certification requirements and client needs related to the regulatory environment.  

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What You Should Know:

– Elation Health, which provides an easy-to-use and
affordable clinical technology platform for more than 7 million independent primary
care clinicians serving 14M+ patients – including an EHR raises $40M in Series
C funding from Al Gore’s sustainable investment firm, Generation Investment
Management.

– Elation’s API-enabled platform also allows
organizations to transform the patient and provider experience and implement
their own models of data-driven, value-based care.

– Company will surpass a milestone this year of
delivering more than 20 million in-office and virtual visits through their
provider network.

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Elation
Health, a clinical-first technology company powering the future of
independent primary care, today announced a Series C financing round of $40
million led by Al Gore’s Generation Investment
Management, a firm that invests in sustainable businesses accelerating the
transition to a more healthy, fair, safe, and low-carbon society. The round
also included participation from existing investors, including Threshold Ventures and Kapor Capital.

Clinical-First Commitment to Independent Primary Care

Independent primary care is one of the few areas in healthcare where upfront investment leads to significant savings in the long term. For every dollar spent on primary care, studies suggest that as much as $13 in downstream healthcare costs are avoided. Increased spending on primary care is also associated with fewer emergency department visits and reduced total hospitalizations and specialty interventions for chronic conditions such as diabetes, high blood pressure, and congestive heart failure

Elation Health was founded in 2010 after siblings Kyna and
Conan Fong struggled to help their father transition his solo primary care
practice from paper charts to a digital system. Born from that experience,
today Elation Health powers the largest network for independent primary care,
with 14,000 independent clinicians caring for seven million patients. The
company offers an EHR
solution, enterprise APIs, revenue cycle services, patient engagement app, and
access to interoperability partners.

The company surpassed a milestone this year of delivering more than 20 million in-office and virtual visits through its provider network. In addition to serving small practices, Elation has partnered with primary care innovators such as Crossover Health and Cityblock Health to provide the underlying clinical platform for technology-enabled, team-based care.

Helping Intendent Practices Shift to Virtual Care Amid The
COVID-19 Pandemic

In 2020, Elation Health’s customer base of independent
practices has faced significant business challenges as primary care shifts to
virtual settings and the pace of insurance and government policy change has
accelerated. The company has responded by expanding its role as a critical
technology partner — including adding HIPAA-compliant telehealth to its core
offering, deepening support for Medicare and Medicaid quality programs, and
delivering new patient engagement capabilities for patients to schedule
appointments and interact with practices. Elation’s API-enabled platform also
allows organizations to transform the patient and provider experience and
implement their own models of data-driven, value-based care.

Expansion Plans

In the year ahead, Elation Health will continue to invest in
its core platform, while adding new capabilities to support business operations
for independent primary care. The company has plans to develop solutions in
billing and payment collection, patient population management, interoperability,
and quality reporting — ensuring practices have the tools to drive high-quality
patient outcomes and business success.

What You Should Know:

– Ro announced it has acquired Workpath, a technology
platform that powers on-demand, in-home healthcare and diagnostics services
nationwide.

– Through this acquisition, Ro’s platform will now
uniquely bring together a patient’s doctor, pharmacy, and
diagnostics/lab–offering a personalized, end-to-end experience with no
insurance required.

– Ro is also announcing a partnership with Quest
Diagnostics, which operates more than 2,200 locations nationwide, to process
its lab tests.

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Ro, the healthcare technology company, today announced it has acquired Workpath, a software platform that enables healthcare companies to offer on-demand, in-home care, and diagnostic services with a simple API. The acquisition will enable Ro to seamlessly integrate virtual and in-person care on its own platform and offer these in-home capabilities to other healthcare companies. The ability to send healthcare professionals to, and conduct diagnostic tests in, a patient’s home significantly expands the scope of Ro’s vertically-integrated platform and advances the company’s strategy of becoming a patient’s first call for all of their healthcare needs.

End-to-End In-Home Care Solution

Founded in 2015, Workpath is a technology platform that powers on-demand, in-home healthcare services nationwide. Workpath’s API enables healthcare companies to dispatch phlebotomists and other providers to perform services ranging from blood draws to vaccinations, all from the comfort of a patient’s home. The company’s full-service platform includes scheduling and dispatch software, a nationwide network of healthcare professionals, diagnostic processing and reporting, and more. Workpath is available to 95% of patients across the country and facilitates in-home healthcare services for clinical trial operators, Fortune 100 companies, and the nation’s largest diagnostic laboratories.

Acquisition Creates A New Paradigm for
Patient-First Healthcare

As part of the acquisition, Workpath will
continue to operate independently as an autonomous entity. Workpath and its API
will continue to be available to other healthcare companies, enabling them to
dispatch healthcare professionals to perform services ranging from blood draws
to vaccinations and other primary care services, all from the comfort of a
patient’s home. The company’s full-service platform includes scheduling and
dispatch software, a nationwide network of healthcare providers, diagnostic
processing and reporting, and more. Ro’s offering of Workpath’s platform will
position the combined company as an integral part of the healthcare industry’s
transition to connect the best of virtual and in-person care.

Enabling End-to-End Care

Ro-affiliated providers will leverage Workpath’s
API to order in-home care or diagnostic services for patients, greatly
expanding the scope of conditions that can be treated or managed through Ro’s
platform. In doing so, Ro will seamlessly connect a patient’s doctor, pharmacy,
and lab on its vertically-integrated platform, enabling end-to-end care from
diagnosis to the delivery of medication to ongoing care. Given that seven of
every ten healthcare decisions require blood work, Ro will start by offering in-home
phlebotomy (blood test) services with results directly delivered through Ro’s
platform.

Zachariah Reitano, Co-Founder and CEO of Ro, said: “Ten years from now, more healthcare services will be delivered online or in-home than in every hospital, doctors office, or pharmacy combined, and this acquisition will help accelerate that change. The powerful new platform we’re creating enables Ro, and countless other healthcare companies, to deliver care whenever and wherever patients need it. We look forward to welcoming Workpath to the Ro family and together setting a new standard for vertically integrated healthcare delivery.”

Financial details of the acquisition were not disclosed.

What You Should Know:

– Google Cloud launches Healthcare Interoperability
Readiness Program to help healthcare organizations achieve healthcare data interoperability.

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Today,
Google Cloud launched the Google Cloud Healthcare Interoperability Readiness
Program, helping organizations achieve data interoperability in advance of
upcoming HHS deadlines and to enable future innovation. Alongside partners like Bain, BCG, Deloitte, HCL,
KPMG, SADA, and more, the Healthcare Interoperability
Readiness Program will help healthcare organizations understand the current status
of their data and where it resides, map out a path to standardization and
integration, and make use of data in a secure, reliable, compliant manner.

Google Cloud Interoperability Readiness Program

This program provides a comprehensive set of
services for interoperability, including: 

– HealthAPIx Accelerator provides
the jumpstart for the interoperability implementation efforts. With best
practices, pre-built templates and lessons learned from our customer and
partner implementations, it offers a blueprint for healthcare stakeholders and
app developers to build FHIR API-based digital experiences.

– Apigee API Management provides the underpinning and enables a security and governance layer to deliver, manage, secure and scale APIs; consume and publish FHIR-ready APIs for partners and developers; build robust API analytics, and accelerate the rollout of digital solutions.

– Google Cloud Healthcare API enables
secure methods (including de-identification) for ingesting, transforming,
harmonizing, and storing your data in the latest FHIR formats, as well as HL7v2
and DICOM, and serves as a secondary longitudinal data store to streamline data
sharing, application development, and analytics with BigQuery. 

– Interoperability toolkit that includes solution architectures, implementation guides, sandboxes, and other resources to help accelerate interoperability adoption and streamline compliance with standards such as FHIR R4. 

COVID-19 Pandemic Underscores Drive to Accelerate
Interoperability

“With COVID-19 underscoring the importance of even more data sharing and flexibility, the next few years promise to accelerate data interoperability and the adoption of open standards even further—ideally ushering in new and meaningful partnerships across the care continuum, new avenues for business growth, and new pathways for patient-centered innovation,” stated in the announcement blog post.  

Interoperability in healthcare is a national disgrace. After more than three decades of effort, billions of dollars in incentives and investments, State and Federal regulations, and tens of thousands of articles and studies on making all of this work — we are only slightly better off than we were in 2000.  

Decades of failed promises and dozens of technical, organizational, behavioral, financial, regulatory, privacy, and business barriers have prevented significant progress and the costs are enormous. The Institute of Medicine and other groups put the national financial impact somewhere between tens and hundreds of billions of dollars annually. Without pervasive and interoperable secure communications, healthcare is missing the productivity gains that every other industry achieved during their internet, mobile, and cloud revolutions.   

The Human Toll — On Both Patients and Clinicians

Too many families have a story to tell about the dismay or disaster wrought by missing or incomplete paper medical records, or frustration by the lack of communications between their healthcare providers.  In an era where we carry around more computing power in our pockets than what sent Americans to the moon, it is mystifying that we can’t get our doctors digitally communicating.   

I am one of the many doctors who are outraged that the promised benefits of Electronic Medical Records (EHRs) and Health Information Exchanges (HIEs) don’t help me understand what the previous doctor did for our mutual patient. These costly systems still often require that I get the ‘bullet’ from another doctor the same way as my mentors did in the 1970s.

This digital friction also has a profoundly negative impact on medical research, clinical trials, analytics, AI, precision medicine, and the rest of health science. The scanned PDF of a fax of a patient’s EKG and a phone call may be enough for me to get the pre-op done, but faxes and phone calls can’t drive computers, predictive engines, multivariate analysis, public health surveillance programs, or real-time alerting needed to truly enable care.

Solving the Surround 

Many companies and government initiatives have attempted to solve specific components of interoperability, but this has only led to a piecemeal approach that has thus far been overwhelmed by market forces. Healthcare interoperability needs an innovation strategy that I call “Solving the Surround.” It is one of the least understood and most potent strategies to succeed at disruptive innovation at scale in complex markets.  

“Solving the Surround” is about understanding and addressing multiple market barriers in unison. To explain the concept, let’s consider the most recent disruption of the music industry — the success of Apple’s iPod. 

The iPod itself did not win the market and drive industry disruption because it was from Apple or due to its great design. Other behemoths like Microsoft and Philips, with huge budgets and marketing machines, built powerful MP3 players without market impact. Apple succeeded because they also ‘solved the surround’ — they identified and addressed numerous other barriers to overcome mass adoption. 

Among other contributions, they: 

– Made software available for both the PC and Mac

– Delivered an easy (and legal) way for users to “rip” their old CD collection and use the possession of music on a fixed medium that proved legal “ownership”

– Built an online store with a massive library of music 

– Allowed users to purchase individual tracks 

– Created new artist packaging, distribution, licensing, and payment models 

– Addressed legalities and multiple licensing issues

– Designed a way to synchronize and backup music across devices

In other words, Apple broke down most of these barriers all at once to enable the broad adoption of both their device and platform. By “Solving the Surround,” Apple was the one to successfully disrupt the music industry (and make way for their iPhone).

The Revolution that Missed Healthcare 

Disruption doesn’t happen in a vacuum. The market needs to be “ready” to replace the old way of doing things or accept a much better model. In the iPod case, the market first required the internet, online payment systems, pervasive home computers, and much more. What Apple did to make the iPod successful wasn’t to build all of the things required for the market to be ready, but they identified and conquered the “surround problems” within their control to accelerate and disrupt the otherwise-ready market.

Together, the PC, internet, and mobile revolutions led to the most significant workforce productivity expansion since WWII. Productivity in nearly all industries soared. The biggest exception was in the healthcare sector, which did not participate in that productivity revolution or did not realize the same rapid improvements. The cost of healthcare continued its inexorable rise, while prices (in constant dollars) leveled off or declined in most other sectors.  Healthcare mostly followed IT-centric, local, customized models.  

Solving the Surround for Healthcare Interoperability

‘Solving the Surround’ in healthcare means tackling many convoluted and complex challenges. 

Here are the nine things that we need to conquer:  

1. Simplicity — All of the basics of every other successful technology disruptor are needed for Health communications and Interoperability. Nothing succeeds at a disruption unless it is perceived by the users to be simple, natural, intuitive, and comfortable; very few behavioral or process changes should be required for user adoption. 

Simplicity must not be limited to the doctor, nurse, or clerical users. It must extend to the technical implementation of the disruptive system.  Ideally, the new would seamlessly complement current systems without a heavy lift. By implication, this means that the disruptive system would embrace technologies, workflows, protocols, and practices that are already in place.  

2. Ubiquity — For anything to work at scale, it must also be ubiquitous — meaning it works for all potential players across the US (or global) marketplace.  Interoperability means communicating with ease with other systems.  Healthcare’s next interoperability disruptor must work for all healthcare staff, organizations, and practices, regardless of their level of technological sophistication. It must tie together systems and vendors who naturally avoid collaboration today, or we are setting ourselves up for failure.  

3. Privacy & Security — Healthcare demands best-in-class privacy and security. Compliance with government regulations or industry standards is not enough. Any new disruptive, interoperable communications system should address the needs of different use cases, markets, and users. It must dynamically provide the right user permissions and access and adapt as new needs arise. This rigor protects both patients from unnecessary or illegal sharing of their health records and healthcare organizations in meeting privacy requirements and complying with state and federal laws. 

4. Directory — It’s impossible to imagine ubiquitous national communications without a directory.   It is a crucial component for a new disruptive system to connect existing technologies and disparate people, organizations, workflows, and use cases. This directory should maintain current locations, personnel, process knowledge, workflows, technologies, keys, addresses, protocols, and individual and organizational preferences. It must be comprehensive at a national level and learn and improve with each communication and incorporate each new user’s preferences at both ends of any communication.  Above all, it must be complete and reliable — nothing less than a sub-1% failure rate.  

5. Delivery — Via the directory, we know to whom (or to what location) we want to send a notification, message, fetch request or record, but how will it get there? With literally hundreds of different EHR products in use and as many interoperability challenges, it is clear that a disruptive national solution must accommodate multiple technologies depending on sender and recipient capabilities. Until now, the only delivery “technology” that has ensured reliable delivery rates is the mighty fax machine.

With the potential of a large hospital at one end and a remote single-doctor practice at the other, it would be unreasonable to take a one size fits all approach. The system should also serve as a useful “middleman” to help different parties move to the model (in much the same way that ripping CDs or iTunes gave a helping hand to new MP3 owners). Such a delivery “middleman” should automatically adapt communications to each end of the communication’s technology capabilities, needs, and preferences..  

6. Embracing Push — To be honest, I think we got complacent in healthcare about how we designed our technologies. Most interoperability attempts are “fetch” oriented, relying on someone pulling data from a big repository such as an EHR portal or an HIE. Then we set up triggers (such as ADTs) to tell someone to get it. These have not worked at scale in 30+ years of trying. Among other reasons, it has been common for even hospitals to be reluctant to participate fully, fearing a competitive disadvantage if they make data available for all of their patients. 

My vision for a disruptive and innovative interoperability system reduces the current reliance on fetch. Why not enable reliable, proactive pushing of the right information in a timely fashion on a patient-by-patient basis? The ideal system would be driven by push, but include fetch when needed. Leverage the excellent deployment of the Direct Trust protocol already in place, supplement it with a directory and delivery service, add a new digital “middleman,” and complement it with an excellent fetch capability to fill in any gaps and enable bi-directional flows.

7. Patient Records and Messages — We need both data sharing and messaging in the same system, so we can embrace and effortlessly enable both clinical summaries and notes. There must be no practical limits on the size or types of files that can easily be shared. We need to help people solve problems together and drive everyday workflows. These are all variations of the same problem, and the disruptor needs to solve it all.  

8. Compliance — The disruptor must also be compliant with a range of security, privacy, identity, interoperability, data type, API, and many other standards and work within several national data sharing frameworks. Compliance is often showcased through government and vendor certification programs. These programs are designed to ensure that users will be able to meet requirements under incentive programs such as those from CMS/ONC (e.g., Promoting Interoperability) or the forthcoming CMS “Final Rule” Condition of Participation (CoP/PEN), and others. We also must enable incentive programs based on the transition to value-based and quality-based care and other risk-based models.  

9. On-Ramp — The iPod has become the mobile phone. We may use one device initially for phone or email, but soon come to love navigation, music, or collaboration tools.  As we adopt more features, we see how it adds value we never envisioned before — perhaps because we never dreamed it was possible. The healthcare communications disruptor will deliver an “On-Ramp” that works at both a personal and organizational scale. Organizations need to start with a simple, driving use case, get early and definitive success, then use the same platform to expand to more and more use cases and values — and delight in each of them.  

Conclusion

So here we are, decades past the PC revolution, with a combination of industry standards, regulations, clinician and consumer demand, and even tens of billions in EHR incentives. Still, we have neither a ‘killer app’ nor ubiquitous medical communications. As a result, we don’t have the efficiency nor ease-of-use benefits from our EHRs, nor do we have repeatable examples of improved quality or lower errors — and definitively, no evidence for lower costs. 

I am confident that we don’t have a market readiness problem. We have more than ample electricity, distributed computing platforms, ubiquitous broadband communications, and consumer and clinician demand. We have robust security, legal, privacy, compliance, data format, interoperability, and related standards to move forward. So, I contend that our biggest innovation inhibitor is our collective misunderstanding about “Solving the Surround.” 

Once we do that, we will unleash market disruption and transform healthcare for the next generation of patient care. 

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About Peter S. Tippett

Dr. Peter Tippett is a physician, scientist, business leader, and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus).  As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.

He was a member of the President’s Information Technology Advisory Committee (PITAC) under G.W. Bush, and served with both the Clinton Health Matters and NIH Precision Medicine initiatives. Throughout his career, Tippett has been recognized with numerous awards and recognitions  — including E&Y Entrepreneur of the Year, the U.S. Chamber of Commerce “Leadership in Health Care Award”, and was named one of the 25 most influential CTOs by InfoWorld.

Tippett is board certified in internal medicine and has decades of experience in the ER.  As a scientist, he created the first synthetic immunoglobulin in the lab of Nobel Laureate Bruce Merrifield at Rockefeller University. 

What You Should Know:

– Human API, the consumer-controlled health data platform
announced it has closed a Series C round of $20M+ this week.

– Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers.

– The platform harnesses a machine learning-powered data pipeline
that structures health data into a consistent format, making it easier for
medical researchers and scientists to use actionable data more quickly and
efficiently while ensuring that patients remain in full control of who their
personal data is being shared with.

---

Human API, a San
Mateo, CA-based company empowering consumers to connect and share electronic
health data with companies they trust, announced today that it has raised over
$20 million in Series C funding. The round includes participation from Samsung
Ventures, CNO Financial Group, Allianz Life Ventures, and Moneta VC, as well as
from existing investors BlueRun Ventures, SCOR Life and Health Ventures, and
Guardian Life Insurance Company. 

The capital will be used to scale new products and services
that enable new product design, granular risk stratification, optimize clinical
trial recruitment, support population health management, automate patient
monitoring, and digitize chronic disease management.

The Next Generation of Health Data Exchange

Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers. The platform
harnesses a machine learning-powered data pipeline that structures health data
into a consistent format, making it easier for medical researchers and
scientists to use actionable data more quickly and efficiently while ensuring
that patients remain in full control of who their personal data is being shared
with. 

However, going one step further than just solving the data
portability issue, the Human API platform offers users various options to make
their data actionable, such as:

– Sharing their information with specific researchers who can put it to good use 

– Enlisting to take part in medical trials or pharma trials 

– Speeding up insurance processes to less than 24 hours

– Taking part in wellness programs provided by their employers.

“By facilitating these transactions,” explains Sean Duffy,
Co-Founder & CEO at Omada Health, “Human API is bringing into being a new
consumer health ecosystem driven by consumer-centric health apps and services.”

Appoints New Chief Commercial Officer

To drive forward this period of growth, Human API has
brought on Richard Dufty as Chief Commercial Officer. Having spearheaded
AppDirect’s growth from early stage startup to Unicorn status in just 4 years,
and having led Symantec’s $1B US Consumer and Cloud business, Dufty brings
extensive experience launching and growing software ecosystems.

Twenty years ago, technology consultants started advising CIOs to build less. That’s when the movement towards Commercial Off the Shelf (COTS) began. 

Today, there are many shops, especially those in small and medium-sized organizations, with few programmers who build new applications from scratch.  

Yes, they have programmers who configure, script, and integrate various applications but very little is built. For the provider community, we have a habit of either sourcing our needs from our Electronic Health Records (EHR) application vendor or buying a “best of breed” application from a niche vendor.

Moving to Software as a Service (SaaS) has even reduced the dread of upgrades. No doubt buying commercial software has enabled all of us to have access to better solutions and in some cases, may have reduced the ongoing run rate. Still, it means technology costs have gone up and a lot of our technology goals have not been achieved. 

For example, interoperability remains a point to point problem. ONC and CMS are still pushing to remove barriers to interoperability and have mandated data exchange with penalties.  

CIOs are struggling with the realities of constraint budgets where new programs are starving while dollars go to pay maintenance, integration costs associated with prior purchases (e.g. tech debt).

New Challenges

Then, in a year of the normal pull-and-tug between maintaining current and delivering new systems, COVID-19 arrived and our planning fell short. Technology teams were challenged as never before. They suddenly needed to:

– Enable teams to work from home – even teams who have never worked remotely.

– Stand up telehealth solutions in days – not months.

– Find a good external data source with statistics to integrate and then discover a newer, better source days later.

– Provide real-time updates on the availability of hospital rooms to leadership.

– Provide rapidly evolving guidance to patients on admissions changes, new requirements for entrance to facilities reduced access to admitted patients.

– Be a trusted, consistent source of guidance to reduce the spread of the disease.

Unplanned work

This was all new, unplanned work. Work that took resources from other budget areas and other teams. Work that didn’t always meet our aim for better patient care or patient experience.

For example, we saw some providers advertising the availability of telehealth services but requiring a patient to call their primary care doctor to schedule instead of requesting an appointment online. Then due to staff shortages, the patient would land in voice mail, further delaying access to care. 

Patients needing tests have been told to get an order from their physician. The truth is telehealth isn’t integrated and isn’t part of our daily processes.  

Unsung hero

The story here is the emergence of an unsung hero you can’t find on the nightly news: our IT Teams. We need to arm this group of heroes with better tools.  Tools where delivery of new programs, updates to existing processes and integrating new data from external sources can be done in days, not months. 

Did your clients link to external data sources such as John Hopkins? Did they need to enable test sources from new partners? Did they need to build new mobile applications to integrate workstations in parking lots and third-party locations?

New approach – Low-Code

Today’s challenges require a new approach that is “low-code.” Low-code is shorthand for an application development environment that is primarily visual and uses simple declarative statements to create applications. The primary goal of low-code is to accelerate program delivery.  

This is surely a goal for every healthcare technology team. As enterprise clients embrace low-code, they can ensure readiness by putting these building blocks in place so clients can realize the promised value:

– Authentication Management through APIs (OAuth)

– Standardized access through APIs

– Management and Monitoring

Preparation

In preparation for the adoption of a low-code application platform (LCAP), it is essential to assess the adoption of authentication best practices. 

The technology landscape now spans on-prem, private cloud, and public cloud solutions requiring a standardized, tokenized approach to authentication. Without this, security processes will inevitably fall short of the CISO’s goals or will require additional manpower to monitor and maintain.  

OAuth is the building block

Given the number of vendors, environments, and the velocity of human interactions (non-employee clinicians, temporary resources of all types, patients, etc.), OAuth is the building block for scalable secure authentication. OAuth is a delegated authentication framework that replaces the need to send credentials in program calls (APIs). 

It has been required by CMS for the interoperability rule as a foundation for data sharing. If you haven’t, invest in a centralized identity management system and move to use OAuth to authenticate service and access requests. Standardizing authentication is foundational. Do it before selecting a low-code vendor.

LCAP platforms deliver a variety of methods to access data from other applications. Typical integration patterns include files, database calls (ODBC, JDBC, etc.), and scripting.  

Now is the time to adopt API-First and design thinking. Stop building point-to-point integrations – the velocity of LCAP will result in a proliferation of connection methods if interfaces are not standardized.

Using APIs – fast delivery

Using APIs will enable faster delivery and better performance.  Providing a set of standardized interfaces that meet the needs of consumers (a fundamental goal of API-First) will reduce test time, production breakage, and upgrade complexity. Don’t wait.  

Doing APIs right requires a culture shift – slapping an API on an enterprise application is not the goal. Delivering APIs that drive consumption and adoption by citizen developers and go-to-market programs will power user experiences that truly do more with less.  

Management and monitoring 

Last but not least is the management and monitoring of your new agile applications, especially the application interactions with your core enterprise applications and external integrations. We have all seen it, a new program or upgrade is delivered, and performance slows to a crawl. 

Monitoring and metering access (limited access to X number of calls per time period) is essential to proactively prevent coding errors and shield your client from bad actors. Knowing who is accessing what, and how the load varies, is necessary to achieve the goals of delivery velocity and efficient use of resources.

API Management vendor leaders include policy engines, management, and embedded analytics in their gateways to protect and scale service integrations.  

Better, faster, cheaper is our mantra (once again, some of us mutter under our breaths). Adopting low-code will accelerate delivery and help us meet the demands of the new normal.  

LCAP demands standardized authentication, application program interfaces (APIs), and secure, monitoring gateways to accelerate adoption while protecting and securing enterprise resources. 

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About Ruby Raley

Ruby Raley is VP of Healthcare and Life Sciences at Axway. Axway empowers customers to compete and thrive in dynamic marketplaces using hybrid integration solutions to better connect their people, systems, businesses, and digital ecosystems. More than 11,000 organizations in 100 countries rely on Axway to solve their data integration challenges. 

What You Should Know:

– Dignity Health Management Services (DHMSO), the largest
health system in the state of California to transform their network health data
into actionable insights.

– With this partnership, the organization will leverage
Innovaccer’s FHIR-enabled Data Activation Platform to better manage healthcare
services for its attributed patients.

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Dignity Health Management Services
(DHMSO), a healthcare management company part of CommonSpirit Health, that helps providers
and payers deliver better clinical outcomes through innovative tools and
technology is
partnering with Innovaccer. As part of
the partnership, DHMSO will leverage Innovaccer’s FHIR-enabled Data Activation
Platform and built-in solutions to enhance its care management approach while
engaging their network providers and payers in real-time.

Transform Network Health Data Into
Actionable Insights

DHMSO will integrate its clinical
and financial data from multiple sources on Innovaccer’s FHIR-enabled Data
Activation Platform. Once the data is integrated on the platform, the
organization will power multiple care processes. This platform supports
critical FHIR API resources and solves numerous data-exchange challenges for
providers and payers. DHMSO will have the advantage of real-time data sharing
and true interoperability with the platform.

To achieve a comprehensive overview
of its network, Dignity Health Management Services will also use InGraph,
Innovaccer’s population health management solution built on top of the
FHIR-enabled Data Activation Platform. DHMSO’s leaders will view drilled-down
analysis of their under-performing parameters through InGraph’s 60+ patient
stratification features and advanced analytics offered by customizable
dashboards. They will be able to identify, have a complete overview of, and
gain insight into their cohort of at-risk patients to track utilization and
trends. The organization will be empowered to implement care management
improvements and follow results within different management spheres, adjusting
as needed to drive optimum healthcare delivery and patient outcomes.
Additionally, billing processes for patient visits will be simplified and
automated through the platform’s automated reporting feature.

Using
InNote, Innovaccer’s point-of-care technology, the organization will furnish
its providers with a full view of their patient’s healthcare journey right at
the moment of care. This will enable DHMSO and its healthcare teams to focus on
closing the care and coding gaps in real-time to deliver quality outcomes with
high efficiency.

“At Dignity
Health Management Services, we believe in keeping our patients happy, healthy,
and whole every day. It is our goal to meet the physical, mental, and spiritual
needs of every patient. This partnership with Innovaccer will strengthen our
approach towards achieving this goal. Innovaccer’s FHIR-enabled Data Activation
Platform will assist us as we work toward improvements in our care delivery,
and will be a great addition to our strategy,” says Dr. Soham Shah, Medical
Director of Clinical Informatics & Quality Management, Dignity Health
Management Services.

What You Should Know:

– Verisk launches its new EHR Triage Engine, a tool that
uses data from consumer-authorized electronic health records (EHRs) to help
life insurers fast-track many applications for coverage.

– The EHR Triage Engine bypasses manual workflows,
leveraging advanced predictive analytics and automation to digitally ingest and
analyze EHRs and the tool can evaluate 95,000 impairments in five minutes or
less.

---

Verisk, a data
analytics provider, announced today the launch of its new EHR
Triage Engine, a tool that uses data from consumer-authorized electronic health records
(EHRs) to help life insurers fast-track many applications for
coverage—potentially cutting decision time from weeks to minutes.

EHR Triage Engine Overview

The typical life underwriting process traps companies and
agents in slow, manual workflows—and subjects customers to intrusive physical
exams and lab work. The EHR Triage Engine bypasses manual workflows, leveraging
advanced predictive analytics and automation to digitally ingest and analyze
EHRs.

The tool can evaluate 95,000 impairments in five minutes or
less, so life insurers can qualify as much as 85 percent of applicants for
coverage with minimal or no underwriter review. With automated processing of
low-risk cases, carriers can provide a streamlined customer experience for the
vast majority of their applications and enable underwriters to focus their
energy on complex risks.

Research shows that it takes four weeks to underwrite the
average life policy, but half of all life insurance shoppers are more likely to
buy if they can forego the most intrusive and time-consuming element—a required
physical exam. The EHR Triage Engine helps respond to those customer
expectations, an effort supported by a team of Verisk experts in biostatistics,
data science, medical research, regulatory compliance, and data privacy.

Development Background

Verisk developed the EHR Triage Engine in collaboration with
SCOR, a global Tier 1 reinsurer. SCOR plans to integrate Verisk’s EHR Triage
Engine into SCOR Global Life’s Velogica underwriting system. The Verisk
solution can also be easily delivered via a stand-alone API or integrated into technology
from FAST, a Verisk business and leading provider of end-to-end software for
the life insurance and annuity markets.

“Many life insurers are looking to implement digital strategies to modernize and streamline their business for a competitive advantage,” said Maroun Mourad, president of global underwriting at Verisk. “Verisk is at the forefront of a revolution in analyzing structured digital health data for insurers that’s shared by their applicants, and is indispensable for automating real-time, low-, or no-touch decision making. This can help insurers deliver a quick purchase process for the vast majority of applicants who are relatively low risk.”

What You Should Know:

– Redox adds data on demand and single sign-on access
features to its cloud interoperability platform to help to simplify the process
of developing software for healthcare.

– Both new features are now available to all customers on
the Redox platform.

Redox
Inc., a Madison, WI-based interoperability platform for healthcare data
exchange, unveiled Data on Demand, which enables software developers to query
any electronic health
record (EHR) or healthcare data source via the Redox API. Powered by a
FHIR-conformant data storage architecture, Data on Demand is pre-built
integration infrastructure designed to simplify and normalize the integration
experience and reduce the technical burden of consuming hundreds or thousands
of messages per day. In addition, the company has added Single Sign-on that allows applications using Redox to make
it easier for providers to launch their products from within their EHR in an
efficient manner. Both features are available to all customers on the Redox
platform. 

Data on Demand and Single Sign-on Simplify the Process of
Developing Software

Redox continues to expand the integration capabilities
healthcare software developers can access through a single API with these new
features:

Data on Demand converts traditional HL7 feeds into a
data store that application developers can query on demand. This provides a
consistent integration experience that works with both the push- and API-based
integrations provided by EHR companies. Regardless of how data is provided by
the EHR, Redox customers can more easily manage the volume of messages and
logic needed to update information, allowing them to focus on getting the data
that they want, when they want it. No other integration vendor can turn HL7
feeds into reusable queries.

Single Sign-On (SSO) allows customers to improve the
provider’s experience with their products by sharing login credentials and
pertinent patient or visit context along with patient data that they’ve
collected. This allows applications on the Redox network to securely connect to
other applications and share the login context for a user. Customers trust Redox
to verify that the SSO request is valid, and Redox normalizes and pulls the
information to launch the application.

“Redox continues to develop the robust integration
capabilities software developers need to navigate the fragmented world of data
exchange and interoperability in healthcare,” said Niko Skievaski, co-founder
and president, Redox. “The Redox API is transforming the way healthcare
organizations access and share data. Our company’s ultimate goal is to enable
the frictionless adoption of technology in healthcare, and we’re making great
strides as the interoperability standard and one-stop-shop for our customers.” 

What You Should Know:

– The latest Chilmark Research report examines how data-oriented APIs are contributing to development and integration efforts across healthcare from the perspective of the developer.

– Reeling from the impact of the COVID-19 pandemic and
seeking more effective ways to implement new functionality, healthcare
enterprises of all kinds are looking to alternatives for prevailing development
and integration practices.

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Unlocking value
from the data scattered across healthcare communities was once a tantalizing
opportunity. After COVID-19,
it is an existential necessity. Chilmark
Research’s latest Market Trends Report, Open APIs in Healthcare: The Future of Data Integration, captures a market whose approach to data access and
integration will be changing substantially in the coming years and introduces a
subvertical within healthcare
IT that anticipates a 16% CAGR through 2025.

APIs Are Still New in Healthcare

Outside healthcare, the ascendance of
data access and integration facilitated by application programming interfaces
(APIs) is the culmination of decades of technology evolution and implementation
lessons with distributed applications. Across the SaaS landscape in particular,
APIs have become the preferred method for accessing data and conducting
transactions across applications and organizations. Developers recognize and
appreciate the value of loosely coupling their applications and data, wherever
each is located.

Inside healthcare, many enterprises are
hesitant on the topic of APIs, seeing them as too big a leap from established,
successful software practices. But they also recognize that eliminating the
need for hard-coded interfaces that must be re-implemented every time an
application or its underlying data changes will deliver higher programmer
productivity and more-responsive applications.

Traditional Integration Methods Fall
Short
Conventional development and
integration approaches proved cumbersome and slow in efforts to contribute to
understanding or responding to the current health crisis. Unlocking more value
from the data scattered across healthcare communities is — post-COVID-19 —
a critical element in clinical and
financial renewal.

“Enterprises across healthcare were already wrestling with challenging market forces and government mandates,” says Brian Murphy, the report’s lead author and analyst. “Open APIs will play a central role for providers, payers, or any healthcare enterprises that intend to better utilize their data and pursue development efforts that make them — and the broader healthcare community — more responsive and adaptable to the demands of a post-pandemic healthcare system.”

Developers Require Accessible Data

Developers find data wherever they can from among a large
and confusing mix of data holders and associated vendors. This report
identifies the sources where different kinds of health-related data are most
likely to be API-accessible. It shows how APIs are already contributing to
development and integration efforts across healthcare and estimates the much
larger potential of widespread adoption.

This report includes detailed profiles on 20 public and
private organizations and their offerings, including 1upHealth, 4Medica,
Allscripts, Apple, Athenahealth, Availity, Blue Button 2.0, Cerner, Change
Healthcare, Datica, Epic, Human API, Meditech, NextGen, NCPDP, Particle Health,
The Sequoia Project, Redox, Surescripts, and Validic.

For more information about the
report, visit https://www.chilmarkresearch.com/chilmark_report/open-apis-in-healthcare-the-future-of-data-integration/

Over 50% of US broadband households are willing to share smartphone data to aid in COVID-19 contact tracing, while another 20% could be convinced provided privacy protections are in place, according to Parks Associates’ new research, COVID-19: Impact on Telehealth Use and Perspectives. The research tracks changes in consumer attitudes and adoption of telehealth services as a result of COVID-19 and measure future interest in telehealth services beyond the pandemic.

Parks Associates’ COVID-19: Impact on Telehealth Use and
Perspectives also notes that those who experienced COVID-19 symptoms are more
willing to share smartphone data to aid in contact tracing than those who have
not experienced symptoms. Still, nearly half of those who have not experienced
symptoms are willing to share their smartphone data.

“Apple and Google have together developed an API and framework that developers, in partnership with public health officials and other stakeholders, can use to build contact-tracing apps,” Hanich said. “The industry can drive widespread uptake of these solutions by emphasizing the public benefits of this data sharing while also stressing the privacy protections in place for anyone who participates.”

Sanofi is to begin preparations in autumn to spin off its active ingredients business and is lining up a potential stock market launch by 2022, according to a press report. 

Citing sources close to the company Reuters noted that the spin-off is part of a plan to boost profits announced by new CEO Paul Hudson in December. 

Hudson joined the company in September and his strategy will also see Sanofi exit diabetes and cardiovascular research. 

Transferring manufacturing of active pharmaceutical ingredients (API) to another listed company will allow Sanofi to focus on vaccines, rare diseases and oncology. 

According to Reuters Sanofi could start marketing the API unit to potential investors in the autumn, while preparing for a potential IPO later in 2021. 

The new company would be headquartered in France and operate with at least 3,100 skilled employees with sales of around a billion euros by 2022. 

Products will be made at six of Sanofi’s European API production sites in France, as well as Italy, Germany, Britain and Hungary. 

Management is trying to decide further details such as whether to list the separated business on the Euronext Paris stock exchange. 

Sanofi’s leaders have also not yet decided what will go into the spin-out, and this will affect its value. 

However the new API business could be valued at between one and two billion euros depending on what is left in and left out. 

France’s state investment bank Bpifrance has been involved in discussions and has considered taking a stake according to the report. 

Other institutional investors in France and Germany have also been approached, Reuters said, although as is always the case with large changes at Sanofi the changes are politically sensitive. 

President Emmanuel Macron has said several times that he wants to diminish France’s heavy reliance on drugs manufactured outside the country. 

The issue is coming to a head during the coronavirus outbreak, where health systems worldwide are struggling to ensure they have adequate supplies. 

Sanofi has already announced that it will cut up to 1,680 jobs in Europe over the next three years. 

Hudson will want to avoid confrontations with the Macron administration after he started a major political row by saying that the US would have first rights to its potential COVID-19 vaccine after becoming an early investor. 

French prime minister Edouard Philippe responded by saying access for all was “non-negotiable”. 

Sanofi’s chairman Serge Weinberg resolved the row by saying on French television that there would be no advance for any country, adding that Hudson’s words had been distorted. 

The post Sanofi set to spin off API business late next year – report appeared first on .

What You Should Know:

– Microsoft released the public preview of Azure IoT
Connector for FHIR (Fast Healthcare Interoperability Resources), the latest
update to the Microsoft Cloud for Healthcare.

– The Azure IoT Connector for FHIR makes it easy for
health developers to set up a pipeline to manage protected health information
(PHI) from IoT devices and enable care teams to view patient data in context
with clinical records in FHIR.

---

This week, Microsoft released the preview of Azure
IoT Connector for FHIR—a fully managed feature of the Azure API for FHIR.
The connector empowers health teams with the technology for a scalable
end-to-end pipeline to ingest, transform, and manage Protected Health
Information (PHI) data from devices using the security of FHIR APIs.

Telehealth
and remote monitoring. It’s long been talked about in the delivery of
healthcare, and while some areas of health have created targeted use cases in
the last few years, the availability of scalable telehealth platforms that can
span multiple devices and schemas has been a barrier. Yet in a matter of
months, COVID-19 has accelerated the discussion. There is an urgent need for
care teams to find secure and scalable ways to deliver remote monitoring
platforms and to extend their services to patients in the home environment.

Unlike other services that can use generic video services
and data transfer in virtual settings, telehealth visits and remote monitoring
in healthcare require data pipelines that can securely manage Protected Health
Information (PHI). To be truly effective, they must also be designed for
interoperability with existing health software like electronic medical record
platforms. When it comes to remote monitoring scenarios, privacy, security, and
trusted data exchanges are must-haves. Microsoft is actively investing in
FHIR-based health technology like the Azure IoT Connector for FHIR to ensure
health customers have an ecosystem they trust.

Azure IoT Connector for FHIR Key Features

With the Azure IoT Connector for FHIR available as a feature
on Microsoft’s cloud-based FHIR service, it’s now quick and easy for health
developers to set up an ingestion pipeline, designed for security to manage PHI
from IoT devices. The Azure IoT Connector for FHIR focuses on biometric data at
the ingestion layer, which means it can connect at the device-to-cloud or cloud-to-cloud
workstreams. Health data can be sent to Event Hub, Azure IoT Hub, or Azure IoT
Central, and is converted to FHIR resources, which enables care teams to view
patient data captured from IoT devices in context with clinical records in
FHIR.

Key features of the Azure IoT Connector for FHIR include:

– Conversion of biometric data (such as blood glucose, heart
rate, or pulse ox) from connected devices into FHIR resources.

– Scalability and real-time data processing.

– Seamless integration with Azure IoT solutions and Azure
Stream Analytics.

– Role-based Access Control (RBAC) allows for managing
access to device data at scale in Azure API for FHIR.

– Audit log tracking for data flow.

– Helps with compliance in the cloud: ISO 27001:2013 certified supports HIPAA and GDPR, and built on the HITRUST certified Azure platform.

Microsoft customers are already ushering in the next generation of healthcare

Some of the healthcare organizations who are embracing the technology include:

– Humana will accelerate remote monitoring programs for
patients living with chronic conditions at its senior-focused primary care
subsidiary, Conviva Care Centers.

– Sensoria is enabling secure data exchange from its Motus
Smart remote patient monitoring device, allowing clinicians to see real-time
data and proactively reach out to patients to manage care.

– Centene is managing personal biometric data and will
explore near-real-time monitoring and alerting as part of its overall priority
on improving the health of its members.