Digital Healthcare – Realizing Interoperability with APIs

© 2015 Akana., Inc All Rights Reserved.

Digital Healthcare - Realizing Interoperability with APIs

Laura HeritageDirector of API [email protected]@akana.com


The Complexities of Receiving HealthcareMultiple players contribute to a successful healthcare outcome for a Patient


Complexities of Providing HealthcareProviders must distribute and receive information from all the Players


First There Were Paper Files Passed Around


Then came Meaningful Use RegulationsMeaningful Use is using certified Electronic Health Record Technology to:• Improve quality, safety, efficiency, reduce health Disparities• Engage patients and family• Improve care coordination and population and public health• Maintain privacy and security of patient health information

http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives

Meaningful Use compliance will result in:• Better clinical outcomes• Improved Population health outcomes• Increased transparency and efficiency• Empowered individuals• More robust research data on health systems

Three stages of adoption with incentives


Enter Electronic Medical Records Software

• Easy to enter the Data

• Not so easy to get the Data Out

• Not so easy to share


EMR Data is Still Exported to a File and Transferred

EMR

email


How To Get To Stages 2 & 3 and A Higher Value Service?

Moving beyond basic integration woes

Unleashing the data in the EMRs and other data sources

Data provides insight for innovation

Differentiate your healthcare services


APIs Provide Foundation For Digital Healthcare

APIs

Application Programming Interface (APIs)


Why Healthcare APIs?

• Brings Data into the Reach of Everyone

• RESTful APIs are developer friendly– Rest can be human readable, via a browser

• SOAP APIs are to an extent developer friendly though not as popular with the developer community

• Leveraging APIs allows you to breaks Data up into chuck which become more easier to use and analyze

• Increases Interoperability for better healthcare outcomes

• Lowers cost of integration


APIs will Solve Integration Woes!

Or Will They?

I can get at the Data easily but what does the Data mean?

How do I map the Data if I don’t know what the Data means?


Enter the FHIR Specification Led By HL7

• Next generation of healthcare standards based off lessons learned and best features of HL7 v2, v3 and CDA product lines.

• Leverages the latest web standards and focuses on implementability

• Open standard and free for all to use and contribute

http://www.hl7.org/fhir/

http://www.hl7.org/fhir/


FHIR Principles

1. Scope and Priorities– Prioritize Implementation– Provide a flexible framework for interoperability– Keeps complexity where it belongs– Supports but does not mandate tight specification

2. Open Development and Implementation Communities– Leverages open source development principles– Is Free to use

3. Technology and Dependencies– Supports multiple exchange paradigms/architecture– Leverages common Web Technologies– Forward and backward compatibility– Requirements are mainstream and minimal.


FHIR Specification Contains 3 Parts

• General Documentation– Describes how resources are defined– Gives background material including definition of data types, code and

XML/JSON formats

• Implementation– How to use resources using REST, Messaging, as clinical documents or

in service based architecture

• Resource List– List of all resources defined by FHIR


FHIR Provides RESTful API

http://server/fhirbase/Patient/2145

http://server/fhirbase/Observation/33455

http://server/fhirbase/Procedure/55643

http://server/fhirbase/Patient/2145

http://server/fhirbase/Observation/33455

http://server/fhirbase/Procedure/55643


FHIR Resources are Generic By Design

What is an Observation?• For an app that monitors Diabetes; Glucose measurement• For an application capturing smoking status; Smoking Status code• For lab results• For genetics


DAFSmokingStatus Profile

Profiles Are a Key Construct that Provide Meaning

• A profile gives a resource meaning when passed along with the resource

• A profiles does NOT change the resource structure

• Systems can potentially automatically determine integration compatibility based on profiles


Argonaut Project Accelerates FHIR

• Workgroup set up to sprint on an implementation of FHIR – Time limited project

• Workgroup provides feedback to FHIR community for changes needed to be made to the standard.

• Provides a Profile leveraging the FHIR specification– Focusing on 16 Resources in the FHIR specification. There are a total of 99 FHIR

Resources.

• Provides Security Implementation Requirements

• Overview Presentation:– http://www.hl7.org/documentcenter/public_temp_7BAB4277-1C23-BA17-

0C98CE9A70DC42B9/wg/argonaut/Argonaut%20Project%20Overview%20and%20Current%20Status-19%20Mar%202015.pdf


The Implementation Of Interoperable Healthcare

Great we have what we need to build the interoperable healthcare APIs:• FHIR Specification for Resources• Profiles for implementation of common healthcare use cases• A security specification

But how do we implement?


Things you need to consider

• Are you going to implement your own FHIR server?• How are you going to govern the creation of FHIR services?• How are you going to version the FHIR services?• How are you going to expose the FHIR API?

– Internally, externally to partners, open api?

• How will you manage consumption of the APIs?– Licenses? Terms of use? Quotas?

• Will you charge for usage? If so how?• How will you secure the APIs?• How will you monitor the system?• How will you monitor consumption?• Can you leverage analytics to provide differentiating healthcare

services?


You’ll Need A FHIR Implementation

• http://jamesagnew.github.io/hapi-fhir/

• HAPI started and is led by our friends in Canada

• Several US healthcare and software entities are contributing to HAPI

HAPI is an Open Source FHIR Library

There are several other FHIR implementations available as well

http://jamesagnew.github.io/hapi-fhir/




Platform Capabilities NeededPlatform

Licensing

Quota Mgmt.

Partner Mgmt.

PCI Compliance

Provisioning

Policy Mgmt.

Monitoring

OAuth

Federation

Analytics

Lifecycle

API/Services

Application

User

Compliance

Gateway

Security

Authentication

Protection

IAM Integration

Encryption

Mediation

Quality of

Service

Paging/Caching

Orchestration

Scripting

Analytics

Operational

Business

API

Policy Based

Embeddable

Charts

OOTB Reports

Cust.

Visualizations

Import

Export

API Portal

Search

Documentation

Groups

Social


Healthcare Solution Platform

API Gateway

FHIR Server

Elastic Search Big Data Store

Multiple Data Sources

FHIR Model Objects

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The Akana Digital Business Platform


Akana API Platform


Akana Healthcare Solution

Akana API Gateway

FHIR Server (HAPI)

Elastic Search Big Data Store

Multiple Data Sources

FHIR Model Objects

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Akana Healthcare Leadership


Flexible Deployment Model


Reduce the Complexities of Providing Healthcare

Providers provide secure, scalable, managed and standardized API access to Electronic Healthcare Records

APIs

Go Digital


API Resources and API University

• Read about our Healthcare Solution– https://www.akana.com/solutions/healthcare-api

• Resource Center– http://resource.akana.com/

• Follow us on:

https://www.linkedin.com/company/akana

https://twitter.com/AkanaInc

https://www.akana.com/solutions/healthcare-api

https://www.akana.com/solutions/healthcare-api

http://resource.akana.com/



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Digital Healthcare – Realizing Interoperability with APIs