We must operate on the lack of e-health interoperability!

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Iryo Network

5 min readMay 3, 2018

E-health is an emerging market with companies rushing to develop different services, platforms and software equipment for it. At the same time doctors and other medical workers are extremely unsatisfied with the results, claiming that e-health medical records increase costs but do not benefit the patients. What is going on?

For all of the enthusiasm around electronic health records (EHRs), the systems that providers have put in place are still limited in their effectiveness because, too often, they don’t talk to one another and only add to the administrative burden that they are intended to help reduce (source).

Interoperability remains one of the key challenges because the e-health medical systems are usually developed to solve specific problems and are not focused on developing standards which would enable them to function as a whole.

As explained by Julia Adler-Milstein, an assistant professor of health management and policy at the University of Michigan at the US Senate hearing on the state of EHRs in the USA, “an agreed-upon set of standards, implemented in a consistent way, would undoubtedly facilitate interoperability, but the underlying issue is that we don’t have the incentives in place to make this a reality,” she added. “EHR vendors do not have a business case for seamless, affordable interoperability across vendor platforms, and provider organizations find it an expense that they often can’t justify.”

This eventually makes many systems unusable since they rely on the data which is “stuck” in another system, rendering them ineffective. One of the latest example of unusable e-health systems is coming from the USA.

A 4.3 billion-dollar deal for the implementation of Cerner to create a seamless digital health system for active duty military and the VA is failing to achieve it’s goals, reports Politico. “Four physicians at Naval Station Bremerton, in the Puget Sound, one of the first hospitals to go online, described an atmosphere so stressful that some clinicians quit because they were terrified they would hurt patients, or even kill them. Prescription requests came out wrong at the pharmacy. Physician referrals failed to go through to specialists. Physicians were unsure how to do basic things such as request lab reports.

Doctors complained it could take 10 minutes to get into the system, which then frequently kicked them out. The military’s ponderous cybersecurity system was largely to blame, but doctors were frustrated contractors hadn’t figured out a way to work around the problems, as they had with the previous electronic record system.”

Why is interoperability so hard to achieve?

One of the core problems is the complexity of the systems.

Charles “Chuck” Christian, vice president of technology and engagement of the Indiana Health Information Exchange, believes it is impossible to ever achieve a national model for interoperability. “I don’t believe there is one way of exchanging data or making it available to whoever needs it at that point of time,” he said. “The size of the database needed to keep all patient information in one location would be huge,” he continued, also expressing some skepticism for how blockchain could be leveraged in this sense. (source)

The second core problem is that hospitals are severely underfunded.

Sixty-two percent of the health IT workers who participated in HIMSS Analytics Annual European eHealth Survey, in fact, said their shop has an insufficient budget for 2017 and 2018. Even though that is down from 68 percent in last year’s survey, HIMSS Analytics said it points to a strong need for more tech investments.

Third core problems is lack of data structure.

EHRs and standard document formats are certainly steps toward interoperability. Though fax machines are still exceedingly — and shockingly — common in healthcare, records are increasingly stored on servers, not shelves. The government essentially required the use of EHRs with the CMS’ meaningful use program, which mandates, among other technological requirements, that providers electronically transfer patients’ summaries of care for at least half the transitions of care. (source)

Fourth core problem are the data silos.

EHRs no longer work with internal, institution-centered data. They work with external universal data through standardized connectivity (modern APIs), and update that data so that everyone connected can see it and use it. No more need for query-response pass-through of copies of data. Next-generation EHRs are more like a collection of apps, designed for the various workflow needs in healthcare. Since they all work off the same shared data, they can be swapped out and improved as needed. (source)

How is Iryo different?

Instead of reinventing the wheel we are thinking outside the box. We are putting the patient in the center of our strategy to decentralize e-health medical records and letting the user have total control over them.

Decentralising the field means that we are solving the challenge of data silos and data structure, since the data is in control of the patients at all times and they have the upper hand on which of the data points gets sent to the doctors. At the same time, developing Iryo network with openEHR standards in mind, we are bringing down data silos and making the data flow more persistent and sustainable.

By connecting clinics with patients and medical researchers into the same system, we are removing several obstacles at once which usually arise when you try to implement a system just for one or two individual parties. From avoiding vendor lock-in to preventing data toxicity, the Iryo network is enabling medical data research while at the same time guarding your privacy at all times.

Privacy by default, the Iryo is implementing decentralized records paired with zero knowledge storage, using blockchain as a permission control tool. So not only is the data encrypted, the only control key resides in the hands of the user.

And finally, since Iryo network is using open-source standards that are recognized by the global e-health industry today, we are providing sustainable model for medical researchers, doctors and patients.

This means the future of e-healthcare will not be plagued by the same problems as the current solutions, since Iryo offers patients to safekeep their data, while enabling researchers to sample it anonymously and health clinics use only the data points they require for medical procedures.

We must operate on the lack of e-health interoperability!

Written by Domen Savič