The Olympics at HIMSS18: International interoperability a new team sport
The Olympic games offer athletes from around the globe a chance to shine on the world stage, showcasing their top-tier talent for all to see. But what’s perhaps lesser known is that they also offer a chance to prove the utility and value of healthcare data interoperability.
The Olympiad lends itself well to such a mission: The biennial nature of the event, and the participation of thousands of athletes from nearly every nation for whom good health is paramount, make it an optimal proving ground to expand interoperability success.
With help from SNOMED International, the HIMSS Olympic Healthcare Interoperability Initiative aims to expand on existing global health informatics standards, using implementation testing and certification from like-minded groups such as Integrating the Healthcare Enterprise International.
OHI officials will show at HIMSS18 how the Olympics over the next decade – the 2020 Summer Games in Tokyo, the 2022 Winter Games in Beijing and beyond – could offer a microcosm of sorts for population health: Using standards-based technology to enable more seamless exchange of health information for the treatment of athletes, trainers and attendees from more than 200 countries.
Todd Cooper, technical lead for the HIMSS Olympic Healthcare Interoperability Initiative, will present the session alongside Michael Nusbaum, vice chair-elect of HIMSS North America Board of Directors and an expert in international interoperability. Cooper offered his perspective on how OHI was developed, and what it hopes to accomplish on the world stage.
Q. How do the Olympics represent a unique opportunity to be a proving ground for interoperability?
A. Change is hard. Change in healthcare is very hard – many times, it seems impossible. The Olympics provide a fantastic context with a two-year cadence of incrementally improving the digital health maturity of communities and countries around the world. It also allows us to showcase the ‘possible’ in advanced digital health technology and to help establish an ever-improving digital health legacy for everyone. A much better investment, in my humble opinion, than new stadia!
All the interoperability problems that you have in a small local project are present in any OHI project – and we hope to have this generate not only the two-year Big Events but also all the smaller, local, interoperability educational/piloting/testing events that will lead up to the Olympics.
Note also that we are not only looking at the main Olympics but also the Paralympics that use the same infrastructure. Think programs like Wounded Warriors.
Q. What are some specific milestones or measurables you're hoping to achieve in the years ahead – in Tokyo, Beijing and beyond?
A. We missed the PyeongChang window, but for Tokyo we hope to have a pilot project that incorporates person identity matching, IPS access, perhaps imaging and some labs, etc., covering three or four countries (perhaps U.S., Canada, Japan and Korea) and spanning athletes and some staff, officials, volunteers and/or spectators.
For Beijing, we hope to have it integrated more into the core Olympics infrastructure and to expand the information exchange available and the countries participating.
OHI is looking to build from one Games Edition to the next. Note that HIMSS Southern California Chapter is leading the HIMSS Interoperability Showcase OHI Demonstration: They are excited by the opportunity that Los Angeles 2028 presents. Yes it is 10 years down the line, but represents a 10-year OHI "game plan" in a part of the world whether athletic excellence and healthcare innovation and excellence advance side-by-side!
Q. While the 2018 Olympic games were a bit too soon for OHI, the next three Olympics will all be in Asia: How are South Korea, Japan and China doing with regard to interoperability, and health IT uptake in general – especially when compared to the U.S.? What's different?
A. Of course, all three are very different cultures. And their population health challenges and political organizations are sufficiently different to make how OHI would approach them significantly different as well.
PyeongChang 2018. Korea is very socially conservative and very hierarchical. So though they have a national health system and provide first-rate care (including medical tourism), their digital health interoperability is actually focused on entering foreign markets with their medical technology, such as PACS systems, versus leveraging that to impact healthcare for their own families at home. They are leaders in international standards efforts. Unfortunately, the 2018 Olympics were "locked down" in 2016, so OHI had no real opportunity to demonstrate anything there.
Tokyo 2020. Japan's technology is very advanced, world class. However, they are also very private and very suspect of the free flow of personal health information. For that reason, a given provider might have fantastic care technology, but moving that information to referrals or a facility in another city is a significant challenge. Japan is also very involved in international health informatics standardization – both for opening foreign markets and at home. It is entirely a cultural inhibitor – and one that many of the younger generation would like to push past.
Many in the digital health ecosystem would love to have a significant OHI Demo at Tokyo 2020.
Beijing 2022. The only way that China will be able to achieve their national healthcare goals as outlined by president Xi during his 2016 address to the G20 summit in Hangzhou is by utilizing cloud-based digital health technology. They realize this, and with a centralized government will make it happen. Therefore, although their digital health maturity has a way to go, they are actively moving in that direction and see the 2022 Games as an excellent opportunity to show that progress and international leadership. Note that they are also much less risk-averse than either of the other two countries – they are much more aggressive.
All three countries have very active IHE National Deployment Committees and hold annual IHE Connect-athons, just like North America, Europe and others.
One aspect of the OHI vision is to work with each community to improve their digital health maturity via participation in the Olympic Games. There were approximately 217 countries represented in Rio 2016. This is moving them from paper to a digital International Patient Summary to full disclosure and access to content.
Finally, since these games are in Asia, there is strong interest among them of integrating standardized traditional Oriental (e.g., Chinese) medicine into what is supported by the OHI program.
Q. How did the HIMSS Olympic Healthcare Interoperability Initiative come about?
A. Mike Nussbaum has a strong background in health IT and especially standards-based solutions and got to thinking, ‘What if someone crashes in front of me? What kind of medical services do the Olympics provide?’
As he dug into this, he found that, from a digital health perspective, the Olympics were completely out-of-date with almost no leveraging of technology to improve safety, care quality and efficiency. That was the genesis of what eventually became the OHI Initiative. There was strong interest in launching a pilot project for the Rio 2016 Games; however, as you know, there were other challenges (like completing building venues and cleaning waterways) that generated so much noise and angst that OHI was drowned out.
After the Rio Games, HIMSS and SNOMED International both saw the OHI vision as a fantastic ‘pure’ opportunity to advance the implementation and use of digital health globally. So they funded the creation of OHI Team and we spent 2017 working the ecosystem – and believe me, the Olympics raises politics to amazing new heights! But they delivered an OHI Program Plan to at the end of October. New HIMSS CEO Hal Wolf, SNOMED CEO Don Sweete and their boards are very pleased with the proposed OHI go-forward plan, and we ended 2017 with their strong support, as well emerging strong support from the IOC.
OHI: Healthcare Interoperability at the Olympic Games is 1 p.m. March 7 in the Venetian, Murano 3301. Also, visit the HIMSS18 Interoperability Showcase to learn more about it, and how to get involved.
An inside look at the innovation, education, technology, networking and key events at the HIMSS18 global conference in Las Vegas.