Ankit Kumar Agarwal
Ankit Kumar Agarwal is a Wharton Graduate and working as “Director of IT” with NewWave Telecom and Technologies Inc. Ankit is passionate about bringing impactful changes in people’s life. Ankit has a you tube channel to discuss the latest healthcare trends and writes blogs to educate people and promote digital Health.
When the internet was in its baby steps, computer systems were required to have their protocols for interacting and reaching the networks as there was no such universal standard on how their systems were different; every time disparate systems needed to communicate with another system, each one needed special software. System developers need specialized and unique software for each server type. For disparate systems to establish the communication channels, new stacks needed to be written for each purpose. These processes often obstruct interoperability when networking is at the initial stage.
The US federal government set up a standard to establish interoperation of the systems. The idea was to ease the flow of network communications across multiple systems, arrive at the right destination, and prevent obstacles in the early networking stage.
Healthcare today is at a similar stage, just like the early internet networking years. Data is the king in almost every business, organization, and entire process flow. When it is seen through the lens of the healthcare industry, data is a backbone for making better clinical decisions, claims to process, and managing critical record systems. When we say critical record systems, it doesn’t always make it easy to share the information between the providers, labs, and payers.
Interoperability is a complex and challenging thing for the healthcare industry today. Different information systems, devices, and applications can access, exchange, integrate, and utilize the data beyond the boundaries to optimize global health needs.
What are the challenges that prevent better care and better health outcomes?
Most healthcare leaders think that a specific technology solution can resolve the problem from the roots. But, in reality, several issues sprinkle water on their expectations.
The major challenge is healthcare system has different technology needs and capabilities of each stakeholder. Some organizations are investing a lot in new data infrastructure, while others struggle to manage and maintain their legacy systems. Many systems are creating new challenges; not all medical specialists are fond of dealing with multiple software systems.
The discrepancies in the data formats by integration issues cause many complications down the workflows, such as:
- Ambiguous data crowded from multiple sources
- Incapability or inability to support integrations with legacy systems
- Data misinterpretation and high-level security risks
- Slow and weak integration processes
- Lack of unification in the format and identification of data sources
- Lack of interoperability standards
Adding to the above list, the lack of true collaboration and understanding of the issue is the major challenge in the interoperability journey. Medical organizations often peep into the process only within a role and fail to see the healthcare system as a whole and cannot understand its core functions.
The collaborative data infrastructure helps improve interoperability, but it needs a better understanding of shared responsibility and the accountability of the leadership teams in the organizations.
Medical organizations need to be in their hands to improve and ramp up healthcare interoperability. One cannot expect that all of these challenges can be eliminated from the roots. Industry pros should actively take steps to improve the situation. There are several pieces of evidence that lack of interoperability causes considerable gaps in clinical history, hinders the administration’s overall performance, brings frustration to the clinicians, and poses a significant threat to the privacy and security of the data.
So, what do you think is getting in the way?
Is it a lack of standardization?
Healthcare data access has always been challenging as it needs more security. It creates a paradox as the data is sensitive and needs privacy. The inability to access the data causes potential harm. Lack of interoperability results in ambiguity around health needs, leading to poor outcomes and an exponential rise in costs
After decades of struggle due to lack of standardization, the health care organizations finally found a solution with FHIR.
What is FHIR?
The industry has established common interoperability standards to consolidate and facilitate medical data exchange. Of course, we have several standards, with HL7 (Healthcare Level 7 International) becoming a hot topic along with its trending new substandard, FHIR (Fast Healthcare Interoperability Resources)
FHIR mainly aims to simplify the implementation without dumbing down the information integrity. It leverages the current logical and theoretical models to provide a consistent, rigorous, and straightforward mechanism for exchanging data between healthcare applications.
The solutions it brings to set up the components as resources that can quickly assemble into the working systems to solve the real-world problems in the healthcare industry at a fraction of the price of existing alternatives in the stack.
The majority of healthcare systems in the United States have adopted FHIR in their health IT practices. The new regulations of the government and interoperability rules need a wider adoption of FHIR. It will become vital for healthcare organizations, especially when receiving the payments for medical services and to understand the FHIR and amalgamate that into interoperability strategies.
The future is FHIR
FHIR is the next big thing in healthcare interoperability. Do you know how to use apps to track your workouts and blood pressure, locate a doctor when you’re sick, and more? FHIR will make that data available not just to you but to your doctor and healthcare providers — meaning, ultimately, better care for everyone.
It wasn’t until January 2020 that a new rule from the government required all federal exchanges to support FHIR 4, the API standard developed by HL7. This rule also created an implementation guide that helps different technologies interact with and interpret data.
Right now, no API standard gets adopted immediately — it takes years for protocols to reach full functionality. But FHIR has gained widespread acceptance and rapidly growing adoption by governments, businesses, healthcare delivery organizations, and many across the globe.
What does this mean for you? It means that you’ll be able to do things like have access to all of your health information in one place (with your permission), receive recommendations for doctors based on your individual needs (and reviews from other patients), and even get reminders about things like medication or doctor’s appointments.
A Quick Snapshot for Understanding FHIR application
Challenge: Unstructured and unorganized personal health records
It’s a challenge when it comes to structuring or organizing unorganized personal health records. The electronic medical record system, famous as EHR, provides a RESTful API that helps consumers access their medical records through a common portal in a mobile application. Here the resource type is either a patient or a member. It provides demographic information to the client. It also records the medical summary, current medications, and other data where many other specialists are out of network EMRs, and it is where FHIR works out well.
The API needs to be secured with OAuth2. There is no other authorization mechanism available today. This API needs to be secure because sensitive documents need protection against unauthorized access. The API needs to provide fast and efficient access to the resources needed by the app developer so that there is no performance penalty for using this API for app development purposes.
Challenge: Issues with Insurance Settlements
While it is possible to use FHIR to exchange information between disparate IT systems, it is best used when the health systems are confined to different geographical regions. Using FHIR in such a setting would help organize and standardize data for easier comprehension by the parties involved.
In an EMR system already running on different standards, you would need to establish the connection with that information before you can leverage FHIR resources like organization resources and practitioner resources. This is where FHIR can come to the rescue of patients who are covered under non-group health plans, which falls under a litany of insurances. Individuals are restricted to medical specialties but involve adjusters and medical experts in such cases. This helps leverage the FHIR resources like organization resources, practitioner resources, and any professional.
Challenge: Secured Document sharing
While it is possible to use FHIR to exchange information between disparate IT systems, it is best used when the health systems are confined to different geographical regions. Using FHIR in such a setting would help organize and standardize data for easier comprehension by the parties involved.
In an EMR system already running on different standards, you would need to establish the connection with that information before you can leverage FHIR resources like organization resources and practitioner resources. This is where FHIR can come to the rescue of patients who are covered under non-group health plans, which falls under a litany of insurances. Individuals are restricted to medical specialties but involve adjusters and medical experts in such cases. This helps leverage the FHIR resources like organization resources, practitioner resources, and any professional.
Strategic implementation of FHIR
The federal rule adherence is mandatory as it may result in compliance issues and regulatory fines. So, healthcare organizations have to plan to adopt the FHIR standard. While planning to implement the FHIR implementation strategy, keep these things in mind:
OpenAPI Specification (OAS) and HL7’s Fast Healthcare Interoperability Resources (FHIR) are two of the most widely used standards in healthcare. However, while they are interoperable, they do not operate together.
Here’s what this means for you:
– With FHIR, you can perform data exchange across disparate systems and platforms and integrate EHRs and other medical devices into your applications.
– Using OAS 2.0, you can connect any system to any other system so your data can be brought to bear wherever needed.
These two standards combined create a powerful way to work with data. It ensures data accessibility and can safely and securely move across existing systems at scale.
So go forth, developers! Seize this opportunity to test your technical knowledge using these standards, which industry experts have carefully crafted over years of collaboration!
Conclusion
FHIR is a complex and rich concept that offers an entirely new approach to health data sharing. While the healthcare industry may be slow to transition from current standards to the newer FHIR standards, the future looks bright. From implementing SOAP style RESTful APIs to defining structured content and linking up data across multiple platforms and databases, it will not be long before we see FHIR implemented in significant healthcare IT systems.
*This article is Peer Reviewed by the Distilinfo Editorial team prior to the publication.*
