Last week, HL7 and Firely hosted HL7 FHIR DevDays. Originally planned as a live event in Cleveland, the organizers turned it into a virtual event because of Covid-19.
Several Lyniate employees participated in the event this year, and here they share their thoughts about what piqued their interest.
Patients Owning Their Data
Christopher Stehno said:
This conference, in contrast to many of the other, similar events I've attended, has been more focused on patient ownership of data. We have heard from several people who have successfully taken their healthcare data into their own hands and through great personal effort have consolidated and curated it so that they can present a more holistic view of their condition to the many practitioners they interact with.
As technologists, we're talking about how we can flip the model of silos of information held rigidly by healthcare institutions to empowering individuals to be masters of their own destiny. And that means getting their own data in their hands.
The ONC and CMS final rules published in May will allow us to start to break down those silos. But as technologists, we all know the importance of privacy and security and the ever-looming specter of identity thieves and fraudsters.
The most interesting talk I attended this week was about an identity model, which again, flips the paradigm from (many) institutions having ownership of identity management to the individual having ownership of their identity and presenting that same identity to the (many) institutions.
In other words, kind of like your driver license: you have one driver license that you use many different places.
In summary, this week has been about giving patients the data, and thereby the power, to own their own healthcare, because nobody is going to care more about your health than you.
Christopher Stehno, Solution Architect, has been working in electronic data interchange and B2B messaging for his entire career. He has worked with HL7 for the last 10 years and has been involved with FHIR since 2015. In his current role as Solution Architect, he regularly participates in FHIR and IHE Connectathons and is currently focused on enabling Lyniate make the leap into cloud-native healthcare interoperability solutions.
Security Considerations Around Patient Ownership of Data
Ben Levy added:
I think the "patient empowerment" stories were very impressive. In my opinion, most healthy people are too busy to really want the power — and it's a big security risk. But, while the government continues to move us all in that direction, it will benefit those with many providers the most.
Carrying your own credentials around instead of registering everywhere or using Facebook/Google to sign in places is very cool. The example they provided was that you could have this thing stored on your phone and take it with you virtually like your driver’s license. After the state gives you your license, you can use it all over to identify yourself without anyone having to call the state to see if the ID is real. So, you get this virtual identification, then whatever you want to log into (new apps, websites, etc.) you share your DID with it/them, and they can figure out that it's authentic, that it's you, and that it authorizes your use.
Ben Levy, Integration Architect, has worked in healthcare integration since HL7 v2.3. He’s been attending Connectathons since 2004.
Synthea, Remote Clinical Decision Support, FHIR Subscription Models, and Bulk Data APIs
And Sean Zitello weighed in with this:
Abigail Watson really impressed me with her Synthea COVID-19 module. Synthea is a synthetic patient generator. It creates FHIR and CCDA documents that can then be persisted in FHIR servers or document repositories. The Module Builder is a UX that lets you craft specific problems or patient cohorts and patient journeys from early signs through procedures and medications, diagnostic reports. Think of SimCity for patients. I have used Synthea in a more generic way previously, but the modules make it possible to create large datasets that may be of specific interest to an integration or application.
I am paying close attention to developments that align closely with the integration and the role of the intermediary. Two of these are a) Remote Clinical Decision Support, a facet of CDS Hooks, and b) FHIR subscription models.
As FHIR expands its field of view from single patient queries into more traditional integration areas like bulk data import and export and subscriptions, it becomes a more complex management problem and one where the traditional integration engine has an important role to play. Applications are where the center of gravity resides in the FHIR world, and we can capture some of that through effective hosting and management of those applications.
They often will not and should not be EHR-bound. Integration gives all applications a chance to expand their scope and focus on the presentation and user interaction rather than data acquisition and transformation.
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