By Jason W BucknerSenior Vice President, Informatics

Health Information Technology Trends 2016

On the heels of some major announcements in the health technology space, 2016 holds new possibilities for technology to transform the healthcare industry. Specifically, we can look for three major trends: convergent technology redefining what’s possible in healthcare, the invasion and widespread use of consumer health technology, and the continued boom in retail healthcare.

2015 was a year of buildup, anticipation, and finally, some bold moves to propel healthcare technologies forward – specifically regarding interoperability of data. In perhaps one of the most anticipated announcements of the year, The Office of the National Coordinator for Health Information Technology (ONC), housed within the U.S. Department of Health and Human Services, released the Meaningful Use Stage 3 requirements in October (optional requirement in 2017, mandatory in 2018).

If you are a physician with an Electronic Health Record (EHR) system and you accept Medicare patients, you likely have gone through the process of becoming Meaningful Use (MU) certified, which means you have purchased an EHR software solution certified by the ONC. All the players in the health tech space had been awaiting the final verdict on how Application Programming Interface (API) technology was placed into the new MU regulations – and it included this game changer: a patient has a right to their electronic health information via an API.

Think about this: if you are a physician and a patient has a healthcare app on their smartphone, this means you must have a compatible API published that the app can utilize to obtain data. EHR vendors are scrambling to ensure they can meet this requirement. There is a myriad of hurdles to overcome with these two being at the top of everyone’s list:

  • How will you ensure your system has the capacity to connect to hundreds of patient apps when your previous connectivity was limited to well-known and defined HL7 2.x connections? (HL7 2.x is a method used to exchange healthcare data.)
  • How do you validate apps? Any time a door to valuable information is opened, there will be those who seek to steal and profit from this information. This will be no different with healthcare APIs so defining the validation process of an app will be critical.

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“Patients will finally be able to obtain their healthcare data using an app of their choosing”

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Internet of Things

These technological changes in the doctor’s office have occurred alongside a growing popularity of internet-enabled devices. It is estimated that 646 million Internet of Things (IoT) devices will be used for healthcare by 2020. Connected healthcare devices can collect and analyze data, automate processes, and more. The new generation of medical or clinical wearables will be equipped with more sophisticated sensing, capture, and analytical functionalities, thus making the clinical utility of those devices more actionable. As IoT and mobile technology continue to explode in 2016, patients will finally be able to obtain their healthcare data using an app of their choosing. How will they obtain their information? That’s where the healthcare API comes in.

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Year of the Healthcare API

An API is a programmatic method that allows for the exchange of data with an application. Modern APIs are typically web-based and usually take advantage of XML or JSON formats. If you are reading this article, you almost inevitably have used apps that exchange data using an API. For example, an application for your smartphone that collects data from your Facebook account will use an API to obtain this data. Weather apps on phones also utilize an API to collect data.

Interoperability
Next let’s take a look at the history of interoperability of healthcare data. HL7 2.x is a long-standing method to exchange healthcare data in a transactional model. The system is based on TCP/IP principles and typically operates with Lower Layer Protocol (LLP) which allows for rapid communication of small delimited messages. The standard defines both the communications protocol and the message content format. No doubt about it, HL7 2.x is incredibly effective for transactional processing of data, but it has been limited in two key areas:

  • Conformity: A pioneering developer of a successful HL7 interface engine once said: “once you have developed one HL7 interface…you have developed one HL7 interface.” In other words, the standard exists but there is not enough conformity to allow this to be plug-and-play. For example, a patient’s ethnicity is supposed to be in a specific location and there is a defined industry standard list of values (code set) to represent ethnicity. In reality, the ethnicity field is not always populated and if it is, it rarely follows the defined code set.
  • Searchability: HL7 is an unsolicited push method, which means when a connection is made, messages simply flow from one system to another. If you are attempting to build a collection of cumulative data over time, this is a mostly sufficient method, but what you cannot do is ask a question and receive a response. Although some query/response methods have existed for years, their adoption has been very sparse in the industry.

Healthcare API: FHIR
There is an emerging standard under the governance of HL7 called Fast Healthcare Interoperability Resource (FHIR) which is gaining significant momentum to become the de facto API for healthcare. It is likely the ONC did not declare FHIR as a requirement because the standard was in draft form at the time the rule was passed. While an EHR vendor can create their own custom API if they choose, it is highly likely that nearly all vendors will take advantage of the FHIR standard in the near future.


Retail Healthcare

The consumer perspective is not new to the retail industry. Observing the healthcare industry through this consumer-focused lens, the retail industry has realized an important and largely untapped opportunity in healthcare care, creating what has become known as “retail care.” Retail care includes walk-in clinics that traditionally accept cash only and offer limited services. CVS Minute Clinic, The Little Clinic, and Walgreens Healthcare Clinic are some of the leaders in this space. According to the Convenient Care Association, the trade association representing retail care locations, there are more than 2,000 of these clinics in 41 states and they have covered 35 million patient visits. In 2016, we’ll likely see retailers forming partnerships with healthcare companies as they begin to fully execute their strategies for becoming the front line of primary care services. This trend of providing services that patients pay for at a much lower cost transforms patients into consumers of healthcare.


Year of the Patient Consumer

The healthcare industry operates unlike most other industries in that its primary focus of revenue is not the consumer of services. Patients consume the services, while health insurance companies pay the bulk of the revenue. Hospitals make money via price negotiations with health insurance companies. Patients are marketed to, but significantly less so than in other industries. With retail healthcare on the rise and patients accessing their health information via an API, hospitals and physicians will be forced to treat the patient as a consumer.


Summary

2016 looks to be the year of the consumer: patients will research, select, and pay for their healthcare –while receiving their personal health data on-demand – via an API. Patients will become empowered to choose where they consume their healthcare based upon convenience, price, and access to data. This consumer-focused trend will shift the traditionally slow-moving large health systems to become more agile and focused on the patient as a customer and consumer of healthcare.


You Weigh In: Are you currently using an app to communicate with your doctor? Take our poll.


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“Patients will become empowered to choose where they consume their healthcare based upon convenience, price, and access to data”

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