I posted a piece on the pragmatism of interoperability a couple of weeks ago, where I outlined what approaches we took at the Parsek to avoid the rabbit hole one can get themselves into when building interoperable solutions (often with the sole purpose of interoperability). And the path we were on, positioned us on the market quite nicely with the configurable and low-code platform we have now.
This article is a bit less about how data exchange is happening with other systems and a bit more about the value of data and what we can achieve with it.
The data is there, let’s use it
Let’s assume the data is there – most often than not, it is now connected, integrated and seamlessly shared between different systems. We achieved this on a technical (arguably also semantical) level with open standards, profiles, frameworks and initiatives. But now that we have that, the next phase of the “evolution” is to make sense of that data.
A holistic approach with the data being used as a foundation stone we can now build use-case-driven solutions on. All to improve the quality of care, make collaboration feasible and have patients benefit from everything that the data makes possible now. You have the data. You have your software. You know the market’s requirements. The world is your oyster! (well, as long as you conform to security restrictions, GDPR, audit considerations, consent modelling, …).
So what did we do at Parsek? A lot. And then we pivoted. And made version two… and pivoted again. A couple of such moves later, we have two main solutions on the market actively used by clinicians in different regions of the world – Vitaly Coordinated Care and Vitaly Multidisciplinary Team Meetings.
Vitaly Multidisciplinary Team Meetings enable effective cross-specialist MDT discussions
Multidisciplinary Team Meetings (MDT) application” is a solution that enables clinicians from anywhere to participate in online tumour boards.
It follows the IHE-specified XTB-WD, which is short for “many different phases all with clearly defined inputs and outputs which, in the end, result in a patient to be holistically and thoroughly discussed on a board”. This means clinicians from very different specialities and organisations can participate (online!), prepare, review relevant documentation, write notes, minutes of the meeting, final report, etc. All with the help of a very intuitive user interface that guides users through the otherwise quite complex workflow definition.
Data coming from other systems give meaning to such a solution. Without it, there would be very little to prepare on, much less to discuss on the board. Users could manually create patients and upload clinical documentation they had previously downloaded from their systems, but that’s such a … 2020 thing. We live in the future now. Data automatically presents itself now (integrations & open standards ftw!).
Interoperable capabilities
Other than that, the interoperable capabilities of our platform allow this to be very tightly and seamlessly integrated into existing EMRs that clinicians are so very locked-in …- I mean: fond of using.
The solution can be context launched from within their familiar software; some clinical data can even be transferred directly to our solution (SMART on FHIR), which opens in the same context the user had within the EMR.
It’s not too far-fetched to say that step one or two of the process is done within one software, and the rest of the flow is done using our solution. It’s what data, open standards and interoperable capabilities of all vendors enable us to do. The seamless and in-sync functioning of multiple systems empowered end-users to promote the best outcomes for patients.
That is, in short, one use-case we’ve covered and really thoroughly used data available to us. At the same time, we publish clinical data produced as a result of that process to the healthcare information exchange (or instead, we make it available in our standard-compliant XDS registry, thus enabling whoever else to do whatever else his mind desires).
Empowering professionals and patient users through Coordinated care
The other solution is the Coordinated Care solution with a pinch of the Vitaly Patient (patient-facing application). I’ll let the video (from 2:00) do the talking here.
Essentially, it’s a solution that enables a holistic approach to patient treatment in the outpatient setting and follows progress on a condition-specific pathway that patients’ care teams put them on. The patient-facing app, integrated with the application for care teams, keeps the patient highly engaged, less frustrated and on top of their care pathway activities while being safely monitored from a distance.
The underlying Dynamic Care Planning (DCP) IHE profile gives interoperable possibilities even to third-party applications that’d want to interact or be part of the pathway.
It’s another excellent use of the data the open standards make possible and fully empowers both professionals and patient users.
THE Vitaly platform
These are all frontend-facing solutions built around use cases that give our platform and data meaning. Underneath it all, there’s a strong foundation. A strong interoperable core enables:
- Auditing service to ensure an audit trail of everything that is going on.
- Context launching capabilities.
- Identity provider (IdP) capabilities that make NHS Login or DigiD integration possible.
- Dynamic Care Planning (DCP service) for care planning capabilities.
- Cross-Enterprise service (XDW) for support of the workflow module.
- Master Patient Index (MPI) to ensure proper patient management. Messaging, appointments, metrics, FHIR compliant CDR (QEDm), XDS, OpenEHR, HL7v2, HL7v3, …..
Giving meaning and purpose to data
Underneath it all, there’s a foundation that – while frontend solutions were trying to find themselves and kept on pivoting – grew stronger and kept improving and bulking up. It became something that is now purely with configuration and low-code adaptability, able to cater to various needs in the ecosystem.
And most importantly, the foundation now enables our frontend solutions to take “data” for granted. To only care about doing what’s best for the patient and give data meaning and purpose.
Gašper Andrejc, Health IT Domain Lead
Views are my own and do not necessarily reflect the official policy or position of any other agency, organization, employer or company.