Oscar and Cleveland Clinic make FHIR a feature

Data exchange in health care is difficult, but Oscar and Cleveland Clinic are using a new standard called FHIR to remove some of the friction

Last summer, Oscar announced a partnership with Cleveland Clinic — an innovative, world-renowned health system — to launch Cleveland Clinic + Oscar health insurance plans. As two organizations working to improve healthcare from different vantages, we seized a rare opportunity to join forces and provide a seamless patient experience. We looked immediately for ways to leverage technology to deliver better care for our inaugural group of members.

One of the first decisions our tech teams made was to adopt a promising new protocol for exchanging data in healthcare called Fast Healthcare Interoperability Resources (FHIR, pronounced fire). FHIR represents an opportunity to make health care systems more interoperable, and we’re excited to work with Cleveland Clinic to push it forward.

FHIR is the future

Despite wide adoption of Electronic Health Records (EHRs), the healthcare industry remains stuck in a rut of fax machines and landlines. Most hospitals and clinics have digitized their own patient data. But as Vox’s Sarah Kliff has reported, it hasn’t necessarily been used for better care: siloed systems and varied data standards have perpetuated doctors’ and insurers’ reliance on pre-internet age technology for data-sharing.

FHIR was designed to transition the industry towards greater interoperability. Adopters of FHIR can quickly stand up a connection between two organizations via web services, and the structure of data exchanged is formatted in programming-friendly languages (like JSON). This makes it easy and flexible to work with. FHIR presents a future in which different pieces of the healthcare system are able to exchange data without long and expensive integration efforts. So we decided to put FHIR to use.

How Oscar and Cleveland Clinic are using FHIR to be more interoperable

When members join Cleveland Clinic + Oscar, they are able to select a Cleveland Clinic Primary Care Physician through our secure mobile and web apps. This way, they can ensure that they’re paired with doctors they’ve seen before or deem compatible for their health needs. Once members select a PCP, they can count on that physician and their Oscar Concierge team to help manage their medical needs and triage their care.

The first project we implemented using FHIR was the tool that allows our members to select the PCP with whom they’ll form a relationship throughout the year. From the day a member signs up, they’re able to select their PCP through our mobile or web app. The FHIR integration means that we’re easily able to pull the list of available doctors from Cleveland Clinic, and allow our members to select one based on their personal health needs. Once a member selects their PCP, we send the data back to Cleveland Clinic so that their providers can begin managing that patient’s care. Results have been encouraging thus far. Just two weeks into their plans, about a third of Cleveland Clinic + Oscar members have put the FHIR integration into action by selecting their PCP.

We’re also in the process of implementing a FHIR integration for direct scheduling. Once live, members will be able to see doctors’ availability and book appointments in three easy taps from their mobile phone. When they use Oscar’s direct scheduling technology to book appointments at Cleveland Clinic, that data is then sent to the doctor’s office to mark that time slot as booked.

Direct scheduling requires no calling, waiting on hold, or hoping that a request is accepted at a later date. And when Oscar implemented direct scheduling in San Antonio, it became popular: 16% of PCP appointments are now booked through direct scheduling there, saving our members precious time and giving them peace of mind.

Even with promising technologies like FHIR, exchanging clinical information remains complicated in our current healthcare ecosystem. We’re proud to have taken a step towards simplifying this process with Cleveland Clinic, and look forward to projects to come.