As we recapped in our last post, the morning sessions at our Redox Interoperability Summit featured a wonderful lineup of sessions, and the second half of the day didn’t disappoint. After lunch, speakers talked about a range of topics – from healthcare AI and genomics to what’s on the product horizon at Redox, and EHRs.
Brendan Keeler, a solutions engineer at Redox, kicked off the afternoon with a state of the union on FHIR, a set of rules on how data is exchanged between systems. He discussed the history behind FHIR with a nod to Grahame Grieve, the father of FHIR, its strengths and weaknesses, and its future.
Keeler shared a clever A-B-Cs of FHIR with attendees:
- APIs – A critical aspect of FHIR and where the industry is headed
- Building blocks – How FHIR eases the transfer of data
- Consumers – How FHIR is being used to enable patient-centered care
- Documentation – Open documentation from day one makes it a universal standard
- Events vs. queries – A focus on queries and pulling information, but it needs to address the gap of events and pushing information.
- FHIR and Redox – Redox helps design FHIR as an HL7 member, develop FHIR through API support, and deploy FHIR.
Keeler stated that the industry must continue to build the momentum for FHIR as a mature standard for the electronic exchange of health information. For the past few years, there has been a lot of progress — Apple is exchanging information with EHRs using FHIR; workgroups are looking to expand. But in order to realize the full value of FHIR, there must be collaboration between EHR vendors, provider organizations and application (app) vendors. The good news is that EHR vendors are responding to market needs and opening up their systems. These moves pave the way for the second generation of software to digitize the healthcare experience.
Marianne Slight, Google Cloud Health product manager, offered a forward-looking view about how AI has the potential to transform healthcare and how Google is leading the way in “Healthcare AI: Are we there yet?” She noted the industry is not there yet with AI since the technology is not quite what it should be, even at leading hospitals.
Slight said Google Cloud is helping to build a platform to make it easier to incorporate AI in apps. Unfortunately, a couple of challenges stand in the way, namely too many standards and “dirty data.” Healthcare data needs to be aligned to do machine learning analytics. Different data formats and terminologies have been a problem. But Google is trying to build tools to help manage these issues with data harmonization and clinical entity abstraction.
Slight also shared interesting statistics showing that the way consumers engage with healthcare is starting to shift. In 2018, there were 200 billion health-related searches on Google, 61% from a mobile device. As this shift starts to happen, there are different requirements for how health systems and payers need to engage with patients. And for physicians to use AI, they must understand how to use it as new models are introduced and the decisions that might change as a result. And like any other technology, it must fit into the physicians’ workflow.
Next up, Lindsey Baab, a software engineer at genomics company Color, shared her experiences integrating Color with EHRs. She highlighted how integration is just the beginning and that working with new data can change what’s possible in a product.
Color offers genetic testing that is convenient and cost-effective for everyone. After starting as a patient-initiated test, Color recognized it needed to get its platform into health systems to make it more accessible. The company partnered with Redox to help integrate with EHRs, but providers ended up using it as a glorified filing cabinet to hold results. Color wanted it to be used in a more impactful way. For example, if a patient takes the genetics test and needs surgery five years later, the information should pop up in the EHR saying the patient might be allergic to anesthetic agents.
Color again turned to Redox to help get discrete genetic results data into the correct format so it could be integrated with EHRs, expanding the impact of Color beyond a static storage system, making the EHR more powerful and enabling the data to be more actionable.
Nijay Patel, SVP of product at Redox, offered a quick overview of Redox’s product roadmap and development plan. Over the past year, the company has seen the network-based approach explode. Apps are scaling beyond the single digits. More than 600 healthcare organizations are processing nearly two billion transactions on the network. Redox is powering integrations to more than 55 different EHRs. In addition to mentioning the recent Allscripts Developer Program partnership and support for USCDI on FHIR, Patel revealed some future efforts, particularly around compliance to the General Data Protection Regulation (GDPR) and the upcoming California Consumer Privacy Act (CCPA), as well as developments on monitoring and alerting tools and analytics, developer guides, and a Redox community portal.
The final session of the day was a thought-provoking panel of EHR industry leaders, moderated by Devin Soelberg, strategic partnerships at Redox; Matt Obenhaus, director and solution executive of the Cerner Open Developer Experience, Cerner; Neeti Gupta, executive director of partnerships, athenahealth; and Lindsey Kramer, associate manager, Allscripts discussed a range of timely topics.
Soelberg asked what the panelists thought independent software vendors (ISVs) needed to do to be successful in working with EHRs. The executives offered helpful tips for ISVs, including bring in physician/clinician champions of their software, spend time at health systems to learn how to expand to other departments, make sure the app meets customer needs, find customer references, and invest in their own growth rather than relying on the EHR marketplace.
The panelists also offered advice on how ISVs can lessen the friction between themselves and health systems in the EHR ecosystem. Selling to health systems is hard so being able to quickly identify the stakeholders that make buying decisions can go a long way. It is important to understand who the stakeholders are and show value to them. “Relationships matter,” said Gupta. ISVs should also be able to describe their solution in a clear manner from the customer perspective.
The group discussed the proposed new regulations of the 21st Century Cures Act that is focused on patient access to healthcare records and the interoperability of those records between patients and providers. The provisions from the ONC aim to prevent information blocking and to expand how patients can access their healthcare data. Obenhaus suggested the industry consider a three-year timeframe to finalize the legislation. Kramer and others were pleased with the industry’s progress and adherence to the core principles of an open data ecosystem as well as the movement towards a value-based ecosystem.
Following this session, attendees enjoyed one of Redox’s famous taco parties while unwinding and networking.
Many thanks to those who attended this year’s Summit! We can’t wait to show you what we have in store for next year :).