Raw notes, mostly unedited yet.
Description from SXSW website:
APIs have reshaped the web into an interconnected network of products and services that provide a seamless user experience and have enabled SaaS companies to take over the consumer and enterprise world. However, healthcare famously suffers from a matrix of siloed, dated technologies.
But where are the healthcare APIs? They’re coming. A generation of startups are taking on the enormous task of building simple, portable APIs for health data. These companies are building solutions that will finally bring about the interconnected health system that we are all desperately waiting for, and could hold the keys to cracking open the health IT market.
Why I attended: Because I am interested in the movement to make Wellness more usable.
What I learned (Post-Op): I had never heard of FIHR and learning about this opened my eyes to the fact that very smart people are working on making standards so that data can be easily exchanged. The first question asked during Q&A tapped into my inquiry this year at SXSW which is this: is it time to completely disrupt the idea of “doctor.”
The very simple phrase the questioner, who I think said he is the “CMO” (?) from the American Society of OBGYN is that doctors don’t actually think in data, they think in stories. Therefore there is a need to really create great data visualization of the patient story.
Conclusions I’m drawing: Big need for UX, content strategy (people who figure out how to tab and label groups of data) in this industry.
The raw notes:
Discussion of EHR (Electronic Health Records)
Making things usable.
“Meaningful use.”
The policy question – a very conservative industry, regulation comes in, then what happens with a product roadmap?
What does it mean for the guy with the computer to start winning? The people in *billing* started to use computers to “win” by streamlining billing (.@JoshCMandel).
So now it is how do we compensate people for giving “value,” e.g., high-quality care.
Vendors are expressing frustration that they need to check the boxes. And if it becomes compensation for box checking or you don’t get paid, the focus becomes box-checking.
The good sort of evil. When Governments light the beacon to get industry to go and do the right thing in the first place.
Commonwell – http://www.commonwellalliance.org/
A still evolving app. Started as a set of EHRs. Growing evil that was taking to a wrong place, good set of technologies helping them to inter-operate. Patient portals and app platforms joined. Where will providers really go for care to take better care of their patients.
“FHIR” is an acronym – Fast Healthcare Interoperability Resources – open-standard – being developed by Health Level 7. Like modern web standards. The goal is to describe the most common kind of Health Care data and how they are used and displayed. They define data models and using REST api, 3rd party apps can use to connect. Can pay to be a member. Creative Commons 0 license.
“Technically, FHIR is designed for the web; the resources are based on simple XML or JSON structures, with an http-based RESTful protocol where each resource has predictable URL. Where possible, open internet standards are used for data representation.”
PIMs – Health Industry Tradeshow. Was in Las Vegas. Lot of buzz around standards. How can we use these standards to plug in apps and services to run seamlessly.
Need open standards to allow for extensibility.
OLAF to authorize apps to connect.
FHIR to structure data
EPIC
CERNER
Medihealth
Hosting sandboxes and working together to try to resolve differences. If 12 different ways to converge API, how do we stay must be this way or optional.
Very valuable to be able to share data across network. On the horizontal side a lot of hope. Need for vendors to come together.
One EHR versus another EHR are not that different.
Human API: Look at underlying semantic model of the data. What’s under the structure (or semi-structure)? You can have the adaptor, but you must look at how these things fit together. Where the universe of things is known, here are all the known medications and dosages, for example. Have to do a lot more interpretation of the data when unstructured.
Mandel: “Interoperability” has lost its meeting so they created “substitutability” – meaning you can swap out old one and switch in new one. You need something much bigger than FHIR. Have to layer a few things on top of FHIR. 1) Security protocols and consistent across every system. 2) Terminology that are used to describe the data. To use successfully need to lock those things down. 3) If you want to lock into EHR, you need User Experience Glue, so you’re not just starting an isolated session.
Steve Hasley – CMO of American College of OBGYN. Has 30K docs that don’t think in data, they think in STORIES, in notes, physical history. Their challenge is getting data in.
Very exciting session.
Mandel: Need to tell the relevant part of the story in a clear way. Being able to build a viz tool on lab results, that’s something cool I can do with an app. When it comes to putting data back into the EHR that is easiest. An API like FIHR defines data in two directions. When we host a sandbox server, can do both things. In terms of real vendor implementations, start with read mostly, or read only.
Asnaani: First thing people wanted for Commonwell was Give me the Notes.
Designer for IBM had two questions about patient experience.
Challenges for privacy on healthcare end. Both privacy and security questions.
Pop answered: Have to be very transparent with end user. Need to let them know what is going from where to where. When you build that into your platform you are enabling consumers to vote with their data.
Work Different 
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