Traditional RESTful APIs Will Not Solve Healthcare’s Biggest Interoperability Problems

Traditional RESTful APIs Will Not Solve Healthcare's Biggest Interoperability Problems
Brian Platz, Co-CEO and Co-Chairman of Fluree

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.


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.


Regence, MultiCare Health System to Deploy HL7 Da Vinci Member Attribution List for Value-Based Care Arrangements

Regence, MultiCare Health System to Deploy HL7 Da Vinci Member Attribution List for Value-Based Care Arrangements

What You Should Know:

– Regence and MultiCare ink first-in-the-nation value-based
care partnership to deliver improved health outcomes at lower costs.


Health insurance provider Regence
and MultiCare Health System,
an independent accountable
care organization (ACO)
have partnered to deploy a first-in-the-nation value-based model
that delivers better health outcomes to members at lower costs while
simplifying administration for health care providers. Regence serves
approximately 3.1 million members through Regence BlueShield of Idaho, Regence
BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and
Regence BlueShield (select counties in Washington). The new approach between
Regence and MultiCare Connected Care—the Accountable Care Organization that is
a wholly owned subsidiary of MultiCare Health System—marks a milestone in the
evolution of value-based partnerships between insurance payers and providers.

Da Vinci Member Attribution List Standard for Value-Based
Arrangements

The partnership will leverage utilized a soon to be
published HL7® FHIR® (Fast Healthcare Interoperability Resources) Standard
“Da Vinci Member Attribution List” which was developed by the HL7® Da Vinci Project for
value-based arrangements.  This national standard provides an
interoperable method to share member attribution data assisting in reducing the
burden on provider organizations managing patient data and allowing providers
to spend more time with patients. The Regence and MultiCare partnership establish
a foundation for the development of future population data interoperability
applications, such as the exchange of data for measuring care quality and
outcomes.

Why It Matters

Value-based arrangements result in improved outcomes, lower
costs and fewer care gaps for health plan members, and higher patient and
provider satisfaction. Providers are eligible to earn financial incentives by
meeting established targets for patient outcomes, costs and satisfaction
scores.

By creating efficiencies and security in delivering patient data to providers more frequently, it allows provider organizations to spend less time acquiring the data and more time with the patient.” said Melanie Matthews, president of MultiCare Connected Care. “It frees up providers to do the work of population health and helps us embrace our mission of partnering for a healing and healthy future.”

Microsoft Deploys COVID-19 Vaccine Management Platform

Microsoft Deploys COVID-19 Vaccine Management Platform

What You Should Know:

– Microsoft launches a COVID-19 vaccine management platform with partners Accenture and Avanade, EY, and Mazik Global to help government and healthcare customers provide fair and equitable vaccine distribution, administration, and monitoring of vaccine delivery. 

– Microsoft Consulting Services (MCS) has deployed
over 230 emergency COVID-19 response missions globally since the pandemic began
in March, including recent engagements to ensure the equitable, secure and
efficient distribution of the COVID-19 vaccine.


With COVID-19 vaccines soon to be available, Microsoft
announced it has launched a COVID-19 vaccine management platform together with
industry partners Accenture, Avandae, EY, and Mazik Global. The COVID-19
vaccine management solutions will enable registration capabilities for patients
and providers, phased scheduling for vaccinations, streamlined reporting, and
management dashboarding with analytics and forecasting.

These offerings are helping public health agencies and
healthcare providers to deliver the COVID-19 vaccine to individuals in an
efficient, equitable and safe manner. The underlying technologies and approach
have been tested and deployed with prior COVID-19 use cases, including contact
tracing, COVID-19 testing, and return to work and return to school programs.

To date, Microsoft
Consulting Services (MCS)
 has deployed over 230 emergency COVID-19
response missions globally since the pandemic began in March, including recent
engagements to ensure the equitable, secure and efficient distribution of the
COVID-19 vaccine. MCS has developed an offering, the Vaccination Registration
and Administration Solution (VRAS), which advances the capabilities of their
COVID-19 solution portfolio and enables compliant administration of resident
assessment, registration and phased scheduling for vaccine distribution. 

Key features of the solutions include:

– tracking and reporting of immunization progress through
secure data exchange that utilizes industry standards, such as Health Level
Seven (HL7), Fast Healthcare Interoperability Resources (FHIR) and open APIs.

– health providers and pharmacies can monitor and report on
the effectiveness of specific vaccine batches, and health administrators can
easily summarize the achievement of vaccine deployment goals in large
population groups

Partnership Offerings

Microsoft partners have leveraged the Microsoft cloud to
provide customers with additional offerings to support vaccine management.
These offerings also apply APIs, HL7 and FHIR to enable interoperability and
integration with existing systems of record, artificial intelligence to
generate accurate and geo-specific predictive analytics, and secure
communications using Microsoft Teams.

EY has partnered with Microsoft for the EY Vaccine
Management Solution to enable patient-provider engagement, supply chain
visibility, and Internet of Things (IoT) real-time monitoring of the vaccines.
Additionally, the EY Vaccine Analytics Solution is an integrated COVID-19 data
and analytics tool supporting stakeholders in understanding population and
geography-specific vaccine uptake.

Mazik Global has created the MazikCare Vaccine Flow that is built on Power Apps and utilizes
pre-built templates to implement scalable solutions to accelerate the mass
distribution of the COVID-19 vaccine. Providers will be able to seek out
specific populations based on at-risk criteria to prioritize distribution.
Patients can self-monitor and have peace of mind to head-off adverse reactions.

Amazon Launches HealthLake for Healthcare Orgs to Aggregate & Structure Health Data

AWS Announces Amazon HealthLake

What You Should Know:

– Amazon today announced the launch of Amazon HealthLake,
a new HIPAA-eligible service enables healthcare organizations to store, tag,
index, standardize, query, and apply machine learning to analyze data at
petabyte scale in the cloud.

– Cerner, Ciox Health, Konica Minolta Precision Medicine,
and Orion Health among customers using Amazon HealthLake.


Today at AWS re:Invent, Amazon
Web Services, Inc. (AWS),
an Amazon.com company today announced Amazon HealthLake, a
HIPAA-eligible service for healthcare and life sciences organizations. Current
Amazon HealthLake customers include Cerner, Ciox Health, Konica Minolta
Precision Medicine, and Orion Health.

Health data is frequently incomplete and inconsistent, and is often unstructured, with the information contained in clinical notes, laboratory reports, insurance claims, medical images, recorded conversations, and time-series data (for example, heart ECG or brain EEG traces) across disparate formats and systems. Every healthcare provider, payer, and life sciences company is trying to solve the problem of structuring the data because if they do, they can make better patient support decisions, design better clinical trials, and operate more efficiently.

Store, transform, query, and analyze health data in
minutes

Amazon HealthLake aggregates an organization’s complete data across various silos and disparate formats into a centralized AWS data lake and automatically normalizes this information using machine learning. The service identifies each piece of clinical information, tags, and indexes events in a timeline view with standardized labels so it can be easily searched, and structures all of the data into the Fast Healthcare Interoperability Resources (FHIR) industry-standard format for a complete view of the health of individual patients and entire populations.

Benefits for Healthcare Organizations

As a result, Amazon HealthLake makes it easier for customers to query, perform analytics, and run machine learning to derive meaningful value from the newly normalized data. Organizations such as healthcare systems, pharmaceutical companies, clinical researchers, health insurers, and more can use Amazon HealthLake to help spot trends and anomalies in health data so they can make much more precise predictions about the progression of the disease, the efficacy of clinical trials, the accuracy of insurance premiums, and many other applications.

How It Works

Amazon HealthLake offers medical providers, health insurers,
and pharmaceutical companies a service that brings together and makes sense of
all their patient data, so healthcare organizations can make more precise
predictions about the health of patients and populations. The new
HIPAA-eligible service enables organizations to store, tag, index, standardize,
query, and apply machine learning to analyze data at petabyte scale in the
cloud.

Amazon HealthLake allows organizations to easily copy health
data from on-premises systems to a secure data lake in the cloud and normalize
every patient record across disparate formats automatically. Upon ingestion,
Amazon HealthLake uses machine learning trained to understand medical
terminology to identify and tag each piece of clinical information, index
events into a timeline view, and enrich the data with standardized labels
(e.g., medications, conditions, diagnoses, procedures, etc.) so all this
information can be easily searched.

For example, organizations can quickly and accurately find
answers to their questions like, “How has the use of cholesterol-lowering
medications helped our patients with high blood pressure last year?” To do this,
customers can create a list of patients by selecting “High Cholesterol” from a
standard list of medical conditions, “Oral Drugs” from a menu of treatments,
and blood pressure values from the “Blood Pressure” structured field – and then
they can further refine the list by choosing attributes like time frame,
gender, and age. Because Amazon HealthLake also automatically structures all of
a healthcare organization’s data into the FHIR industry format, the information
can be easily and securely shared between health systems and with third-party
applications, enabling providers to collaborate more effectively and allowing
patients unfettered access to their medical information.

“There has been an explosion of digitized health data in recent years with the advent of electronic medical records, but organizations are telling us that unlocking the value from this information using technology like machine learning is still challenging and riddled with barriers,” said Swami Sivasubramanian, Vice President of Amazon Machine Learning for AWS. “With Amazon HealthLake, healthcare organizations can reduce the time it takes to transform health data in the cloud from weeks to minutes so that it can be analyzed securely, even at petabyte scale. This completely reinvents what’s possible with healthcare and brings us that much closer to everyone’s goal of providing patients with more personalized and predictive treatment for individuals and across entire populations.”

Google Cloud Launches Healthcare Interoperability Readiness Program

Google Cloud Launches Healthcare Interoperability Readiness Program

What You Should Know:

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


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.  

To Solve Healthcare Interoperability, We Must ‘Solve the Surround’

To Solve Healthcare Interoperability, We Must ‘Solve the Surround’
Peter S. Tippett, MD, Ph.D., Founder & CEO of careMesh

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. 


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. 

Human API Raises $20M+ to Scale User-Controlled Health Data Ecosystem

Human API Raises $20M+ to Scale User-Controlled Health Data Ecosystem

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.

Apple Rolls Out Health Records on iPhone to the UK, Canada

Apple Rolls Out Health Records on iPhone to the UK, Canada:

Today, Apple announced
the Health Records feature within the Health app is now available for users in
the UK and Canada to securely view and store their medical records right on
their iPhone, with their privacy protected at all times. Oxford University
Hospitals and Women’s College Hospital has been selected the first healthcare
institutions in the UK and Canada to make this feature available to their
patients.

How Health Records Works

Health Records creates a direct connection between medical
institutions and a patient’s iPhone, allowing users to see a central view of
their allergies, conditions, immunizations, lab results, medications,
procedures, and vitals across multiple institutions, and to be notified when
their data is updated. Apple utilizes a direct, encrypted connection between
the user’s iPhone and the healthcare organization to protect patient’s privacy.

All Health Records data is encrypted on device and protected
with the user’s iPhone passcode, Touch ID, or Face ID. Apple worked closely
with Cerner, Epic, Allscripts, and InterSystems to enable the FHIR (Fast
Healthcare Interoperability Resources) standards-based integration with the
Health app for their UK and Canadian customers.

To date, over 500 institutions currently support Health
Records on iPhone, listing more than 11,000 care locations. Previously,
patients’ medical records were held in multiple locations, requiring patients
to log in to each healthcare provider’s website to piece together their health
information manually.

Availability

The Health Records feature in the Health app is available to
patients of the medical institutions listed below.

UK

– Oxford University Hospitals NHS Foundation Trust – Oxford,
UK

– Milton Keynes University Hospital NHS Foundation Trust –
Milton Keynes, UK

Canada

– Women’s College Hospital – Toronto, Ontario

– St. Joseph’s Healthcare Hamilton – Hamilton, Ontario

– Mackenzie Health – Richmond Hill, Ontario

Bridge Connector Lands $25.5M to Expand Healthcare Integration Platform

Bridge Connector

What You Should Know:

– Bridge Connector raises $25.5 million in Series B funding to advance interoperability layer for healthcare organizations as demand for integrated health data intensifies during COVID-19 pandemic.

– The investment will support the growth of Destinations,
the company’s new integration-platform-as-a-service (iPaaS) that connects
health data systems using use-case-based interoperability blueprints to speed
integrations with major vendors.


Bridge Connector,
a Nashville, TN-based interoperability company changing the way health care
communicates, today announced it has raised $25.5 million in Series B funding led
by Axioma Ventures. The round was also joined by all existing investors,
including veteran investor Jeff Vinick, and brings Bridge Connector’s total
funding to over $45 million.

COVID-19 Underscores Growing Demand for Integrated Health
Data

The last decade has seen an explosion of digital health platforms and the U.S. health care system has taken incremental steps toward achieving interoperability between them. In March, the Department of Health and Human Services (HHS) issued new rules that force formerly closed vendor solutions to become interoperable.

However, the COVID-19 pandemic has exposed the urgent need for data liquidity as healthcare providers across the country have struggled to share essential patient information and provide comprehensive care via remote delivery methods such as telehealth. In the face of the pandemic’s disproportionate effect on minority communities, the industry has also recognized the critically important role that social determinants of health — the environments in which we are born, live and work — play in our overall well-being and the need to make this information available to health care providers.

A True Interoperability Layer for Healthcare

Founded in 2017, Bridge Connector provides a suite of vendor-agnostic integration solutions and a full-service delivery model, helping health care vendors, providers, and payers more easily share data between disparate systems, such as electronic health records (EHRs) or patient engagement solutions. The company’s technology is designed to democratize health care by allowing organizations of any size to equitably connect data systems and empower care teams with the most accurate patient data in real-time. Unlike other health care interoperability vendors, Bridge Connector’s unique approach does not lock customers into a forced data model or proprietary APIs, instead of employing a vendor-agnostic integration layer that works across data models without the need for standardization.

The investment will further support the company’s increasing
market share in healthcare interoperability and growth of Destinations, a new
integration-platform-as-a-service (iPaaS) that connects health data systems
using use-case-based interoperability blueprints to speed integrations with
major vendors.

Recent Integrations with Key HIT Stakeholders

The new funding comes shortly after Bridge Connector finalized various collaborations with some of the most influential stakeholders in health IT, including Epic, Allscripts, and Salesforce, as well as other system integrators such as MuleSoft. Those collaborations represent calculated steps toward creating a centralized hub of integration solutions for all data platforms that any health care provider or payer can access. The average hospital today uses approximately 16 disparate electronic health records platforms that limit data sharing within the walls of a single hospital, let alone between separate hospitals.

Microsoft Releases Public Preview of Azure IoT Connector for FHIR to Empower Health Teams

Microsoft Releases Public Preview of Azure IoT Connector for FHIR to Empower Health Teams

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.