Interoperability the Missing Link for #DigitalHealth Apps by @msharmas
In the mobile first world, in India we have 204.1 million smartphone users in 2016 [ http://bit.ly/2arR8z7 ] , it is only natural to find startups using the mobile as the way to acquire customers by developing mHealth based products and services and offering these via an app.
While it is a great way to provide accessibility and affordability of healthcare via mobile health solutions, it is also important to understand the need to ensure interoperability of the healthcare data.
Today we have apps for Diabetes Management, Appointments Scheduling, Continuous Monitoring, Remote monitoring, Activity monitoring linked with wearables, women and child health, cardiology, telemedicine, secure messaging apps, etc. The list in the past couple of years has really grown exponentially. And that is great, since i too believe the phone to be the centerpiece of a delivering healthcare based services.
However, one part seems to be missing in the Go-to-Market rush, INTEROPERABILITY !!
It reminds one of the scenario we often come across in healthcare regarding medical devices, which traditionally were never developed for the purpose of sharing data with other systems and it just sufficed that they are connected to the patients and display the readings which the doctor is able to view during her rounds.
And I find the same happening with the DigitalHealth Apps.
I have been following some of the DigitalHealth Startups that have developed apps that cater to one specialty or another. I have come across most of the mHealth apps to be trying to build in the capability to be a patient’s one stop shop for healthcare related data. And in doing this they are duplicating the patient health record. Now there is a specialised personal health record in each mHealth App (just like the medical device).
Imagine if each of the mHealth app provides a feature for the patient to upload and store their records, soon we will have more “silos of information” than we ever had before. Multiply that with the various apps a single user might have on her phone for capturing one or the other healthcare related parameter.
And the problem of solving the interoperability of patient information will continue to be an area of concern.
Its therefore very important for the mHealth apps to start the app development process keeping in mind the Interoperability Standards in healthcare and incorporate. I think this should be the first step in the app development process and in fact patients and the healthcare VCs, investors should ensure the ability of the app to “interoperate” medical records out-of-the-box. The question that one should ask before downloading and using an app should be, will I be able to share my medical data with my Doctor, in a Standard format.
Quality & Interoperability
I am part of a great whatsapp group, that was discussing this very issue in its entierity. While I will not be able to share what was discussed there by the eminent folks from Healthcare Informatics in India, I would like to share my thoughts on the topic. And by doing this I acknowledge their thought provoking discussion on the group.
Just as there is no compromise on quality, why should there be a compromise on interoperability.
Take for instance the medical devices, no one insisted on interoperability, or the cost of enabling interoperability was perhaps higher than the cost of the machine, that no one went for it. It was perhaps thought, its OK, anyways the doctor goes on her rounds she will see the information then. We compromised on interoperability then.
Similarly, today if we take a ‘whatsapp way’ out to interoperability, we will not have demanded for the “right way” of doing things, we would simply have been taking the same approach as before, “its OK, we might as well just use whatsapp”.
There is a cost to quality, which IMHO should not be compromised at any cost. There is a cost to interoperability, which again should not be compromised at any cost. Interoperability should be a plug’n’play option and not a separate service that the vendor chooses to provide, if paid for. It should not be a “Option”, add-on.
Take for instance, the mobile apps, last i checked there were 100,000 “medical apps” on the various app stores. How many of these are interoperable? If earlier we had to contend with medical devices that were not plug’n’play interoperable, now we are facing a bigger problem with apps.
There should not be a compromise on interoperability, at any cost !! We as a community should push for it and insist on it !!
On the topic of Sharing & Interoperability, I don’t see a difference between sharing and interoperability, there is a particular way in which the medical information needs to be exported out of the host system. Maintain its context and understanding behind the recording. Whenever, I have asked a Doctor about a value and its reasoning, they have always asked for “Clinical Context”. In healthcare, we ideally should not separate the two. Clinical context, is another interoperability issue, there is a format in which patient data needs to be shared. It maintains the context, which to my understanding is important vis-a-vis the clinical data.
Solutions to the Problem
With the advent of the apps, the EHRs should have the ability to “add” apps data to the patient EHR allowing for incorporating the mHealth App Data into the patient’s longitudnal record. Not only should the data be included in the longitudnal record, the EHRs should allow for the analysis of various parameters that have been received from the mHealth app.
Apps should not try and provide a medical records capability, instead they should provide interoperability capability to send and receive patient medical records data.
The Patient Medical Records data that has been created in the mHealth Apps should be generated and have the ability to be exchanged with any of the EHRs or other Apps.
When a mobile user deletes a mHealth app from her device, any data stored for the patient should automatically be sent to the patient’s email as a HL7 enabled document. Providing a summary and detailed medical record information of the patient. These should be downloadable into any EHR or another app.
And there you go, its fairly simple and we look forward to you sharing your experiences with our community of readers. We appreciate you considering sharing your knowledge via The HCITExpert Blog
Team @HCITExperts [Updated: 29th May 2016]
Author
Manish Sharma
Founder HCITExpert.com, Digital Health Entrepreneur.
Articles by the Author
- TRIVENI: A remote patient monitoring solution via @msharmas — Part 1
- Health ID as Patient IDs unifier in India by Manish Sharma
- 5 Steps towards an Integrated Digital Health Experience in Indian Healthcare in 2016
- Top Healthcare & Digital Health Predictions for 2016
- Zen Clinicals: An Activity & Workflow based solution (1 of 3)
- RFID in Healthcare: Usecases from Hospitals
- 10 Solutions for the Healthcare IT Fringes
via Blogger http://bit.ly/2ad56s1
July 28, 2016 at 08:51AM
