Over the past couple of decades, many industries — including healthcare — have undergone a digital transformation and changed the way we do business. In the healthcare world, technology has an especially important role to play, with the potential to create efficiencies and new opportunities for digital experiences that can improve our ability to care for patients. But there has been one main obstacle: interoperability. This issue has come to the forefront as the pandemic-driven increase in telehealth has put digital health experiences front and center.
As early healthcare technologies — such as electronic health records (EHRs) — proliferated, their developers did not have a future in mind where it would be necessary to integrate with dozens of new applications. eMarketer estimates “the US will spend nearly $16 billion on electronic health record (EHR) and electronic medical record (EMR) systems in 2022, up 11.7% from 2020” — creating a huge opportunity for interoperability providers.
Today, EHRs — the central repository for patient information — need to communicate with other applications that enable clinicians to do work more efficiently and monitor patients remotely. With that in mind, the healthcare industry has begun working toward a future where all digital applications will work together — and one standard is at the heart of this progress.
“Fast Healthcare Interoperability Resources is a standard describing data formats and elements and an application programming interface for exchanging electronic health records.”
“Fast Healthcare Interoperability Resources® (FHIR®) is a Health Level Seven International® (HL7®) standard for exchanging healthcare information electronically. It is the next generation exchange framework being adopted by the healthcare community to advance interoperability.”
The Fast Healthcare Interoperability Resource (FHIR) has emerged as a solution to challenges in healthcare technology. FHIR protocol allows developers to join disparate systems together and link systems that would have otherwise been unable to communicate. The key to all of this lies within the FHIR resources. As Jennifer Bresnick puts it, “A FHIR resource can be an individual packet of information that include metadata, text, or particular data elements, but can also be bundled into collections that create clinical documents, similar to the C-CDA, but much more flexible.”
FHIR aims to make healthcare technologies work together as seamlessly as the web applications consumers have come to take for granted, ultimately allowing access to data no matter what EHR underpins the infrastructure. New apps and EHR systems are often built with this functionality in mind, but it is still common to run into legacy systems that present challenges — even different departments in the same hospital may be working with the same API and using it differently.
At Vessel Partners, we ran into our own interoperability issue when building the PRISM app. We teamed up with MedStar Health to create an app that relies on a computer-adaptive assessment system to administer an evidence-based set of questions derived from the Patient-Reported Outcomes Measurement Information System (PROMIS). When building PRISM we determined that MedStar Health’s EHR did not support all of the FHIR resources we needed to build PRISM. To address this shortcoming, we built FHIR House, a middleware that allowed PRISM and the EHR to work together seamlessly and provide patients’ with a better remote monitoring experience.
While we have had a few opportunities to create FHIR compliant apps at Vessel, the potential use cases are unlimited:
While interoperability has long been a practical problem for developers and end users, it also became a regulatory issue when The 21st Century Cures Act went into effect in 2016. The act is “designed to help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently.” Data portability has also become an increasing concern — both in practice and for legal reasons — making interoperability a must-have for any modern healthcare practice. That’s why Vessel Partners has made FHIR House open-source and available for other digital health app developers to use in their own work.
As the industry continues to evolve, using FHIR-based standards to develop digital healthcare apps will ensure your product’s success now and in the future. If you want to learn more about FHIR House or how to ensure your digital health app is FHIR compliant, contact us.
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