Open Platforms for Healthcare Applications
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HIMSS MN Presents: Open Platforms for Healthcare Applications Thursday, August 21, 2014
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Today's Electronic Health Record (EHR) offerings inhibit the ability to develop the next generation of clinical applications for providers to provide the best possible care and patients to become more engaged. Such offerings are designed as monolithic silos of storage and end-user experience that use proprietary methods for accessing key functionality. While large health care providers typically have physical control over their data, they lack in having functional control. This barrier makes it virtually impossible for data to be easily accessed by other applications without very costly and time-consuming migration strategies. As a result, the pace of innovation is greatly stymied by closed systems that appear to be all-too-prevalent in the healthcare industry. This session presents a strategy of vendor-neutral, public, open Application Programming Interfaces (APIs) and advocates for their use in developing open platforms for healthcare applications.
Transcript of Open Platforms for Healthcare Applications
HIMSS MN Presents:
Open Platforms for Healthcare Applications
Thursday, August 21, 2014
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HIMSS MN 2014-2015 Event CalendarMonth FormatAugust 21st Webinar – Open Platforms for Healthcare ApplicationsSeptember WebinarOctober Expert PanelNovember Midwest Fall Technology Conference (Chicago)December WebinarJanuary Advocacy EventFebruary WebinarMarch Networking EventApril HIMSS National Chapter Reception (Chicago)May 14th Annual Spring ConferenceJune 3rd Annual Charity Golf TournamentJune Twin Cities Summer SocialJuly SE Minnesota Summer SocialAugust Webinar
Today’s Speakers
Keith ToussaintExecutive Director
Collaborative DevelopmentMayo Clinic
Ken BobisAdministrator
Chief Technology OfficeMayo Clinic
Open Platforms for Health Care Applications
An Open Interface Approach
Presented to HIMSS MNAugust 21, 2014Keith M. ToussaintKen G. Bobis, PhD
Agenda
Definitions The problem Solution vision Business value An example Further research
Definitions
Health Care Organization (HCO) EMR Application Interface / API / Messaging Standard Ecosystem Open Interface
EMR Application
Application that is integral to the delivery of patient care, but not found in the institution’s core Electronic Medical Record
◦ Document Viewer, EMR Viewer, Pt. Itinerary, smartplatforms.org
Interface / API / Messaging Standard Interface
◦ A point where two systems, subjects, organizations, etc., meet and interact Tape data transfer; interface engine
API◦ Application Program (API) or Web Services (WS) Interface
A callable program interface ValidatePatientNumber, ValidateDate
Messaging Standard◦ Rules by which an interface is maintained◦ An agreed upon message format
HL7, FHIR
Ecosystem
(biological) A biological community of interacting organisms and their physical environment◦Rain Forest, Prairie, Coral Reef
(software) A set of businesses functioning as a unit and interacting with a shared market for software and services, together with relationships among them◦Wintel, iOS, Android, Java
Biological Ecosystem
Software Ecosystem
http://subprint.com/blog/it%27s-the-ecosystem,-stupid
Open Source Software Ecosystem
Open Interface
open (small ‘o’)◦May be used by others◦Control retained by the author◦Traditional view of “open”
Open (big ‘O’)◦Author-independent◦Emerging view of “Open”
Open Interface <> Open Source
The Problem Practice functionality needs are huge
◦ More than a single provider organization can satisfy◦ Years to implement workflows in existing products◦ New capabilities removed from “The Gemba”
Closed architectures◦ No access to data sources and business logic
Product lock-in◦ Product B may be more conducive but … switching
costs are prohibitively high
Current State
Data Storage and Computing Infrastructure
Core Clinical Informatics Functionality
User Interface
EH
R X
Monolith
Y
Viewer 1
Tool 1
Viewer 2
Tool 2
Legend:
Vendor provided, HCO Managed HCO provided and managed
Solution Vision Embrace Open APIs
◦ Author-neutral interfaces ◦ Reduce product lock-in
Layered architecture◦ Separating application, platform and storage functionality
New Value Network◦ New problems require new solutions◦ New business models with new value network
participants Common infrastructure
◦ Available to all – but not required
Future State
Data Storage and Computing Infrastructure
Core Clinical Informatics Functionality
User Interface
EH
R
PoC Tool 1
Vendor 1
LegendVendor provided and
managedHCO provided and managed
Vendor 2
HCO 1 Vendor 3
PoC Tool 2 PoC Tool 3
Open interfaces
Open interfaces
Business Value
Strategic value to HCOs
Leverage common core capabilities Minimize capital expenditures Enable rich collaboration Focus on differentiating technology Reduce vendor “lock-in”
Financial value to HCOs
Common platform to meet MU Establish common application frameworks Improved Innovation on reporting and
analytics Cost savings through shared physical
infrastructure
Operational value to HCOs
Enabling Pay-as-you-go tools Minimal up-front costs Same quality tools for all
Value to Newcomers
Enable new value network of application innovation◦Shared core functionality◦New capabilities on existing ‘stack’◦Enabling consistent tools across the spectrum
of care Reduce innovation friction
Existing Efforts
Industry Examples
FHIR HealthKit CommonWell Alliance Smart Platforms.org Continua Health Alliance OpenEHR OpenMRS
HL7 Fast Health Interoperability Resources Fast and easy to implement Implementation libraries Free for use Interoperability out-of-the-box Path from HL7 Version 2 and CDA Web standards compatible Support for ReSTful architectures Human-readable message formats
About FHIR
http://www.hl7.org/implement/standards/fhir/summary.html
Is it big “O” open? Yes!◦ Non-proprietary standards◦ Enables local extension of the standard◦ Well-defined process for evolving the standard
What is missing?◦ Definition of layered architecture◦ Clear description of “separation of concerns”◦ Example of such an architecture:
A Robust Health Data Infrastructure prepared by JASON for ONC: http://healthit.gov/sites/default/files/ptp13-700hhs_white.pdf
FHIR considered
JASON interoperability architecture
Data Storage and Computing Infrastructure
Core Clinical Informatics Functionality
User Interface
Previous Forays from Tech
Microsoft HealthVault Google Health Optum Health Cloud
Further Research
Cloud-based deployment architectureCatalog of required of servicesFlesh out business valueOperational policies & procedures for
member HCOsProtocols for EMR & Ecosystem
interactionsCommon local & public architecture
requirements
Wrap up / Summary
Current State is sub-optimal Loosely-coupled architecture Open APIs
◦Understanding the difference between small ‘o’ and big ‘O’
Now possible to make a shift Can be driven by providers Opinions invited on how to proceed
Today’s Speakers
Keith ToussaintExecutive Director
Collaborative DevelopmentMayo Clinic
Ken BobisAdministrator
Chief Technology OfficeMayo Clinic
Open Platforms for Health Care Applications
An Open Interface Approach
Presented to HIMSS MNAugust 21, 2014Keith M. ToussaintKen G. Bobis ,PhD
