Digital Healthcare – Realizing Interoperability with APIs
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In this webinar you will learn: • What FHIR is and where it came from. • Why FHIR is important to healthcare interoperability. • The key technical aspects of FHIR. • What it takes to build the next generation platform for healthcare interoperability. • How to get involved.
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Digital Healthcare – Realizing Interoperability with APIs
- 1. © 2015 Akana., Inc All Rights Reserved. Digital Healthcare - Realizing Interoperability with APIs Laura Heritage Director of API Strategy @heritagelaura laura.heritage@akana.com
- 2. © 2015 Akana., Inc All Rights Reserved. The Complexities of Receiving Healthcare Multiple players contribute to a successful healthcare outcome for a Patient
- 3. © 2015 Akana., Inc All Rights Reserved. Complexities of Providing Healthcare Providers must distribute and receive information from all the Players
- 4. © 2015 Akana., Inc All Rights Reserved. First There Were Paper Files Passed Around
- 5. © 2015 Akana., Inc All Rights Reserved. Then came Meaningful Use Regulations Meaningful Use is using certified Electronic Health Record Technology to: • Improve quality, safety, efficiency, reduce health Disparities • Engage patients and family • Improve care coordination and population and public health • Maintain privacy and security of patient health information http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives Meaningful Use compliance will result in: • Better clinical outcomes • Improved Population health outcomes • Increased transparency and efficiency • Empowered individuals • More robust research data on health systems Three stages of adoption with incentives
- 6. © 2015 Akana., Inc All Rights Reserved. Enter Electronic Medical Records Software • Easy to enter the Data • Not so easy to get the Data Out • Not so easy to share
- 7. © 2015 Akana., Inc All Rights Reserved. EMR Data is Still Exported to a File and Transferred email
- 8. © 2015 Akana., Inc All Rights Reserved. How To Get To Stages 2 & 3 and A Higher Value Service? Moving beyond basic integration woes Unleashing the data in the EMRs and other data sources Data provides insight for innovation Differentiate your healthcare services
- 9. © 2015 Akana., Inc All Rights Reserved. APIs Provide Foundation For Digital Healthcare APIs Application Programming Interface (APIs)
- 10. © 2015 Akana., Inc All Rights Reserved. Why Healthcare APIs? • Brings Data into the Reach of Everyone • RESTful APIs are developer friendly – Rest can be human readable, via a browser • SOAP APIs are to an extent developer friendly though not as popular with the developer community • Leveraging APIs allows you to breaks Data up into chuck which become more easier to use and analyze • Increases Interoperability for better healthcare outcomes • Lowers cost of integration
- 11. © 2015 Akana., Inc All Rights Reserved. APIs will Solve Integration Woes! Or Will They? I can get at the Data easily but what does the Data mean? How do I map the Data if I don’t know what the Data means?
- 12. © 2015 Akana., Inc All Rights Reserved. Enter the FHIR Specification Led By HL7 • Next generation of healthcare standards based off lessons learned and best features of HL7 v2, v3 and CDA product lines. • Leverages the latest web standards and focuses on implementability • Open standard and free for all to use and contribute http://www.hl7.org/fhir/
- 13. © 2015 Akana., Inc All Rights Reserved. FHIR Principles 1. Scope and Priorities – Prioritize Implementation – Provide a flexible framework for interoperability – Keeps complexity where it belongs – Supports but does not mandate tight specification 2. Open Development and Implementation Communities – Leverages open source development principles – Is Free to use 3. Technology and Dependencies – Supports multiple exchange paradigms/architecture – Leverages common Web Technologies – Forward and backward compatibility – Requirements are mainstream and minimal.
- 14. © 2015 Akana., Inc All Rights Reserved. FHIR Specification Contains 3 Parts • General Documentation – Describes how resources are defined – Gives background material including definition of data types, code and XML/JSON formats • Implementation – How to use resources using REST, Messaging, as clinical documents or in service based architecture • Resource List – List of all resources defined by FHIR
- 15. © 2015 Akana., Inc All Rights Reserved. FHIR Provides RESTful API http://server/fhirbase/Patient/2145 http://server/fhirbase/Observation/33455 http://server/fhirbase/Procedure/55643
- 16. © 2015 Akana., Inc All Rights Reserved. FHIR Resources are Generic By Design What is an Observation? • For an app that monitors Diabetes; Glucose measurement • For an application capturing smoking status; Smoking Status code • For lab results • For genetics
- 17. © 2015 Akana., Inc All Rights Reserved. DAFSmokingStatus Profile Profiles Are a Key Construct that Provide Meaning • A profile gives a resource meaning when passed along with the resource • A profiles does NOT change the resource structure • Systems can potentially automatically determine integration compatibility based on profiles
- 18. © 2015 Akana., Inc All Rights Reserved. Argonaut Project Accelerates FHIR • Workgroup set up to sprint on an implementation of FHIR – Time limited project • Workgroup provides feedback to FHIR community for changes needed to be made to the standard. • Provides a Profile leveraging the FHIR specification – Focusing on 16 Resources in the FHIR specification. There are a total of 99 FHIR Resources. • Provides Security Implementation Requirements • Overview Presentation: – http://www.hl7.org/documentcenter/public_temp_7BAB4277-1C23-BA17- 0C98CE9A70DC42B9/wg/argonaut/Argonaut%20Project%20Overview%20and%20C urrent%20Status-19%20Mar%202015.pdf
- 19. © 2015 Akana., Inc All Rights Reserved. The Implementation Of Interoperable Healthcare Great we have what we need to build the interoperable healthcare APIs: • FHIR Specification for Resources • Profiles for implementation of common healthcare use cases • A security specification But how do we implement?
- 20. © 2015 Akana., Inc All Rights Reserved. Things you need to consider • Are you going to implement your own FHIR server? • How are you going to govern the creation of FHIR services? • How are you going to version the FHIR services? • How are you going to expose the FHIR API? – Internally, externally to partners, open api? • How will you manage consumption of the APIs? – Licenses? Terms of use? Quotas? • Will you charge for usage? If so how? • How will you secure the APIs? • How will you monitor the system? • How will you monitor consumption? • Can you leverage analytics to provide differentiating healthcare services?
- 21. © 2015 Akana., Inc All Rights Reserved. You’ll Need A FHIR Implementation • http://jamesagnew.github.i o/hapi-fhir/ • HAPI started and is led by our friends in Canada • Several US healthcare and software entities are contributing to HAPI HAPI is an Open Source FHIR Library There are several other FHIR implementations available as well
- 22. © 2015 Akana., Inc All Rights Reserved. Platform Capabilities Needed Platform Licensing Quota Mgmt. Partner Mgmt. PCI Compliance Provisioning Policy Mgmt. Monitoring OAuth Federation Analytics Lifecycle API/Services Application User Compliance Gateway Security Authentication Protection IAM Integration Encryption Mediation Quality of Service Paging/Caching Orchestration Scripting Analytics Operational Business API Policy Based Embeddable Charts OOTB Reports Cust. Visualizations Import Export API Portal Search Documentation Groups Social
- 23. © 2015 Akana., Inc All Rights Reserved. Healthcare Solution Platform API Gateway FHIR Server Elastic Search Big Data Store Multiple Data Sources FHIR Model Objects LifecycleManager Analytics Developer Engagement CompleteAutomationandManagement OperationalAnalytics,APIAnalytics,BusinessAnalytics
- 24. © 2015 Akana., Inc All Rights Reserved. The Akana Digital Business Platform
- 25. © 2015 Akana., Inc All Rights Reserved. Akana API Platform
- 26. © 2015 Akana., Inc All Rights Reserved. Akana Healthcare Solution Akana API Gateway FHIR Server (HAPI) Elastic Search Big Data Store Multiple Data Sources FHIR Model Objects AkanaLifecycleManager AkanaEnvision Akana Community Manager CompleteAutomationandManagement OperationalAnalytics,APIAnalytics,BusinessAnalytics Akana Healthcare Leadership
- 27. © 2015 Akana., Inc All Rights Reserved. Flexible Deployment Model
- 28. © 2015 Akana., Inc All Rights Reserved. Reduce the Complexities of Providing Healthcare Providers provide secure, scalable, managed and standardized API access to Electronic Healthcare Records APIs
- 29. © 2015 Akana., Inc All Rights Reserved. API Resources and API University • Read about our Healthcare Solution – https://www.akana.com/solutions/healthcare-api • Resource Center – http://resource.akana.com/ • Follow us on: https://www.linkedin.com/company/akana https://twitter.com/AkanaInc
Notas del editor
- Hello, I’m Laura Heritage and thank you for joining my webinar on Digital Healthcare – Realizing Interoperability with APIs. I find the healthcare industry extremely fascinating and I am very excited to be focusing on the healthcare space. Healthcare is one industry where if you get a nullpointer you could drastically alter someone’s life. As you get see in this presentation getting the data to the right person at the right place at the right time, drastically affects an outcome for a patient.
- Lets take a look at the complexities of receiving healthcare. There are several players that must work together to help you. We all need medical help at some point. If not you, think of your grandparents, your parents, or spouse. And when you receive healthcare you hope that everything is connected and streamlined. Most of the time when you are receiving care You are under a huge amount of stress and you don’t care if they are separate businesses or entities. Them working together determines your wellbeing and outcome. Plus, you are paying for it!! If you are lucky enough to live in a location where you have a choice on who your providers and people who services are going to be using. You are going to choose those who are connected. You go to your general PR actioner, You might need a specialist You could have some labs, Like my grandma you might have a device inserted into your brain to help controls Could need some medication from the pharmacy For example, I use target, and shopko as my pharmacy as they are connected and easy. I don’t have to carry a prescription. I have been doing this for years now.
- Now the complexities of providing healthcare. The patients as we said before expected everything integrated and streamlined. They don’t care that the Ambulatory service is different from the Hospital services or that transcripts are in a different system. We are in a digital ages. Consumers of our services just expect more. They can do their banking on their phones! Healthcare should be integrated. The truth is though, Providers have a very difficult task. The must distribute and receive information from all players in the space
- First there were paper files passed around. I remember when I had my first two children. My medical file was just that a big fat file that was passed around. Then just four to five years ago I remember my healthcare provider moving to digital records. A lot of the data is still transferred between entities by scanning files into PDFs and sending through email, printing out that information when you get it and sticking it into your own file system. * As you can imaging, this way of sharing files took a long time, lots of resources costing patients and providers time and money and sometimes mistakes happened. Besides the life changing event that the mistake cost patient. It also Costing both patients and providers even more time and money
- Then came Meaningful use regulations. This was really introduced in 2010 which corresponds to my providers adoption of their electronic system. This is the regulation to digitize healthcare records in order to Improve quality, safety, Enable more engagement with the patients and family Maintain.. There are three stages to Meaningful use. Stage 1 started back in… Incentives were given to those providers who met the criteria. Now however instead of incentives there could be penalties if not meeting meaningful use.
- Enter Electronic Medical Record software.. I remember when my provider first adopted the system. It took a couple of months until things became streamlined. Lots of complaints but now it is working smoothly. As you can imagine everyone had their own EMR systems.
- Still exported out of EMR – Maybe printed out and file the old way Maybe attached to an EMR But still not very easy to get the data out of that PDF, in a timely manner and do any sort of decision processing on it.
- How do you differentiate your healthcare services?
- APIs provide the foundation for Digital Healthcare I am not talking about the traditional APIs for application to application communication of the past. I’m talking about APIs in terms of the API Economy of the Digital world. APIs that allow easy access to the data trap in systems. Restful apis… . Some EMRs are starting to provide API access.
- SOAP - you can’t easily give a clinician a SOAP endpoint and say put this in a browser to see if this is the data you are looking for.
- Immutable FHIR ojects