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Orgs take two approaches to creating interoperability platform

Many in healthcare are trying to figure out how to effectively make interoperability happen. Two healthcare organizations take two different approaches to creating interoperability systems.

The lack of interoperability has plagued healthcare for years and, unfortunately, it is still a problem. Many have mulled over approaches ranging from vendor pledges to third-party software.

To solve this problem, two healthcare organizations -- Partners HealthCare's Health Innovation Platform and Health2047's Switch network -- are working to create their own interoperability platforms.

"We've really reached this point where there's this juxtaposition of different factors that are coming together, from increasing cost pressure within the healthcare environment to later availability of underlying IT infrastructure that can provide access to new forms of data, as well as better access to existing forms of data, to machine learning coming into play," said Sandy Aronson, executive director of IT at Partners HealthCare Personalized Medicine in Boston.

Doug Given, CEO at Health2047 in San Francisco, added that the delivery of care healthcare is fragmented and that silos of information continue to happen within healthcare organizations.

Doug Given, CEO, Health2047Doug Given

"That's led to all kinds of problems with liquidity of data," he said. "If you don't have the right information at the right place, at the right time, you're always impaired in terms of the quality of decision-making, whether it's a care decision or a value decision of a care plan, or whether it's using a population level of general, I call it, rules."

Partners HealthCare's Health Innovation Platform

With the help of Persistent Systems, headquartered in Pune, India, Partners HealthCare is building an open source platform that will integrate applications directly into clinical workflow, as well as enable greater exchange of data.

Sandy Aronson, executive director of IT, Partners HealthCare Personalized MedicineSandy Aronson

Aronson explained that the interoperability platform is built using SMART on FHIR and rests on a microservices architecture built on Java's JHipster. While these microservices perform functions such as security and the logging of information, it also helps with the access to data, he said.

"So taking that and open sourcing that with the goal of creating a platform that other institutions can implement and, once they've implemented it, the top of the platform should create a uniform service, surface, that we can then take apps that we build in our institution and other schools in their institution and exchange them," Aronson said.

If you don't have the right information at the right place, at the right time, you're always impaired in terms of the quality of decision-making.
Doug GivenCEO, Health2047

He added that they are looking to incorporate i2b2 functionality as well -- an open source, web-based application.

Partners HealthCare and Persistent Systems have built out one application so far, Aronson said. He explained that this application is geared toward helping patients who have undergone a bone marrow transplant and need a platelet transfusion to increase their platelet counts find matching donors whose platelets will work for them in their body.

"It turns out that all of the data needed to dramatically reduce the likelihood of [rejection] exists within the hospital system, but it's spread out into many different systems," Aronson said. "We've built this app that links to those different systems and displays the information."

This particular application is being piloted and the goal, Aronson said, is to build out more applications and then open source the applications on the platform so that anyone anywhere can use it and access information.

Health Innovation Platform and genetic variants

Aronson added that another goal of creating the Health Innovation Platform was not only to create an interoperability platform that would enable data sharing, but also the sharing of genetic variants.

"It's not uncommon to find a genetic variant that has either never been seen before or has been seen very few times before," he said. "And when that happens, you often don't know what that variant means."

Aronson explained that the Health Innovation Platform allows laboratories to track these genetic variants and accumulate knowledge over time. Furthermore, this infrastructure has been hooked into the EHR as well so that when knowledge changes on a variant, a proactive alert can be sent to the physicians of patients who may have that variant and let them know there is new knowledge.

"These tests are typically done for patients with ... a highly debilitating disease," Aronson said. "So getting that information to that clinician for that patient becomes critical."

Interoperability platform: Health2047's approach

When it comes to interoperability in healthcare, Health2047 is tackling the problem by creating a network.

Charles Aunger, CTO, Health2047Charles Aunger

This requires nodes of data users and data sources, Given said.

"As you establish a large number of nodes you end up with a network," he said. "Then as you start exchanging data among those sources and users, you develop a network effect. ... The more groups are involved ... and interfacing with the ... network and the more data they're exchanging, the more valuable it becomes."

This network is called the Switch network and the goal is to create a common mechanism to share data.

"We're a data transport mechanism," said Charles Aunger, CTO at Health2047. "We enable the data to be obviously moved ... through very interesting cloud mechanisms."

In addition to the Switch network, Health2047 is also getting other healthcare organizations on board to participate.

"There are multiple platforms out there and tech organizations are capable of producing these," Given said. "[But] they don't develop broad enough networks."

Next Steps

Epic and Cerner working together to create interoperability

Lack of interoperability main issue with EHRs

Interoperability essential to population health analytics

This was last published in November 2017

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