Bringing the promise of digital health to fruition

The challenges: interoperability and security
By Aashima Gupta
12:13 PM
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The digital health imperative is upon us. With advancements in technology, the opportunities are bound only by our imagination. Recent investments in digital health are telling signs of the disruptive forces at play and the future that is just waiting to happen.

With the advent of arrays of sensors that track a myriad biomarkers ranging from activity, nutrition, heart rate, cholesterol level, glucose levels, sleep to those that can even detect stroke, consumer technologies have ushered in a new era of health management. 

Health applications are consumerizing health management. Investment is pouring in, resulting in an abundance of health apps—50,000 health apps in the app store and growing— claiming to act as health advisors, help you stay fit, or better manage your chronic conditions such as diabetes, hypertension, epilepsy, and asthma.  These apps are powered by APIs – the often “hidden,” but critical technology that securely connects applications to each other and to the data that powers them.

We are at a cusp of the consumer driven health revolution. But for total health agenda to succeed, we need a new approach: one that goes beyond the apps and the sensors and makes better use of APIs to deliver the interoperability and security required to overcome our current challenges.

The challenges: interoperability and security

For the very first time, consumers are demanding change; they want to have their health information at their fingertips through their mobile phone. Health apps can be engaging and immersive for the consumers. On the other hand, they are creating more data silos, scattering consumer health data in various clouds. 

Furthermore, these apps have no way of easily connecting to electronic health records or pulling meaningful information about the consumers even with their consent. This results in creating redundant copies of records, not to mention the inconsistency and confusion that follows after you have downloaded a dozen apps.  

The lost opportunity is the inability to have a complete picture of one’s health – total health.

The next wave of digital competency will need to address connecting these siloed data in a meaningful way and empowering consumers to leverage the information to be participatory in managing their own health.

Connecting the disparate pieces of information is a daunting task. At the heart of the challenge is the notion of data liquidity – the movement of data across the app clouds, payers, providers, and pharmacies silos.

Lets draw a parallel.  After you start to manage your finances through Mint.com, you quickly wonder how you did it before. Mint provides the one-stop shop for all of your financial information, becoming a smart connector to a number of the financial institutions that store your data. Data is secure, liquid, and translates.

Healthcare is as diverse as the financial industry. We get care from multiple providers (specialists,

Primary care physicians, endocrinologists, podiatrists, radiologists, orthopedics, urgent care orthodontist etc.), service providers (pharmacy, labs etc.) and systems (insurers, employers, Medicaid etc.)

If Mint.com enables us to be more aware of our financial well being, would we not want the same simplicity as it relates to our health and wellness? 

The journey to data liquidity requires two things: data interoperability and security. 

One of the key attributes of personal financial management is the concept of data interoperability. Things such as ATMs work across various banking organizations without consumers having to worry about the underlying mechanics for data exchange.

Healthcare organizations need both syntax and semantics interoperability In order to facilitate the easy movement of consumer data across institutions. According to the Department of Health and Human Services (HHS), 20 percent of preventable medical errors are caused by lack of immediate access to relevant health information. 

Recent announcements from HL7 about Project Argonaut bring a breath of fresh air into the healthcare standards arena. Inspired by the proven technologies of the Internet, the goal of Project Argonaut’s goal is to replace the heavy, complex health interoperability standards that exist today with a leaner Internet friendly version. As a consumer, I am glad that finally healthcare is learning from the successes of banking, finance and retail, which thrive on experiences that aggregate, content and provide a holistic view. 

Project Argonaut will accelerate the development and adoption of HL7’s Fast Healthcare Interoperability Resources. The vision can be brought to life through APIs based on FHIR standards. These lightweight APIs will act as a mechanism to securely authenticate and manage the flow and integration of data across the boundaries.

The Office of California Attorney General released a new report which shows that 18.5 million Californians had their personal data exposed in 2013, an increase of 600% from the previous year. It is just a matter of time before something similar happens in Healthcare. A breach of financial data has a cost and is annoying, but a breach of healthcare data arguably has an even greater impact. Health data is durable. If breached, knowledge about confidential disease information like HIV status, mental health can cause irreparable long-term impact to the customer. 

API promote a secure and interoperable digital health ecosystem

We are at a cusp of the consumer driven health revolution. For total health agenda to succeed, we need a new approach; one that goes beyond the apps and the sensors. 

The new approach needs to enable data liquidity, while keeping it secure. This mandates a need for a solution that ensures security, auditability, authentication and trust of the consumer data being transmitted across the network enabling small and large organizations to participate in this interoperability journey. Without these capabilities data liquidity would remain a pipe dream effectively locking the data in the respective apps and EHRs silos preventing any significant dents in improving the outcomes and lowering the costs of delivering care.

That’s where APIs come in. APIs – ubiquitous and powerful digital connectors -- hold the keys to unlocking the promise of digital health ecosystem. APIs allows companies to securely share, manage and measure data across millions of devices and digital touchpoints. 

APIs built on a secure platform can enable health data siloes to communicate with one another and move information between them. They are at the heart of connected health ecosystems where data is unlocked, allowing it to move across extended stakeholders. APIs can even be used to verify and manage consent of the consumers at every call.

APIs can help us deliver on the vision of self-managing our health or helping those we hold dear with their healthcare needs. This can’t be delivered through sensors and apps alone. APIs delivered in a secure environment are key to enabling a consumer friendly Internet to rapidly emerge.