We’ve been having the discussion for a long time about interoperability of healthcare data. Although, maybe I should say the discussion has been around lack of interoperability of healthcare data. However, I think we sometimes get confused in the discussion because there are a lot of different ways to share healthcare data. From the hospital point of view this becomes even more complex. Here’s a look at some of the various ways that we could and in many cases should share data.
Software to Software – When someone is talking about healthcare interoperability, they are usually talking about software to software data sharing. Some of the most common examples in healthcare include EHR to HIE, EHR to EHR, or even within modules of the same EHR or HIS system. You can also expand this to include Lab to EHR, Radiology to EHR, ED to EHR, Pharmacy to EHR, etc. In all of these cases, it’s one piece of software sharing data with another piece of software.
One of the biggest challenges with this sharing of data is that even when these software systems are the same software it can be hard to share the information in a ways that’s useful for the receiving system. Sure, we could just transfer some PDF files which are easily viewable and can be easily digested by the receiving system. The sending system and receiving system both understand the PDF format and can easily create, send and receive the file in a way that both know.
Unfortunately, a PDF file listing your drug history isn’t nearly as useful as an XML or other data driven file that contains each of the elements of your drug history including things like drug name, strength, date prescribed, data filled, etc etc etc. The challenge is not creating a file like this. That’s quite academic. The pain point is communicating to the new system the format of the file that you created so that the receiving system can ingest that file into that software in a proper manner.
There are plenty of more points on why software to software exchange is a challenge. However, we’re going to see more and more software to software exchange in healthcare going forward. We’re literally just at the beginning of this revolution.
Device to Software – Another common place for healthcare data exchange is from a medical device to software. Some of the most common examples are the blood pressure cuff and thermometers that are connected directly to an EHR software. Things like EKG’s are also becoming more and more common. In the hospital there are an amazing number of high end clinical devices that also integrate their data with software.
From my experience, these device to software integrations are pretty straightforward. The device manufacturers set the standard and there are relatively few medical device manufacturers out there. Usually it’s a one (device) to many (EHR and HIS software) which makes things easier. Although, we’ll see how this changes as more and more medical devices are built on top of various smart phones and tablets like the iPhone and iPad.
Software to Device – The exchange of data from software to a device is less common. Yes, I am excluding devices like a smart phone which to me are just an extension of the software. A better example is something like Cisco’s unified messaging system where you can have data from your EHR or HIS system sent to your Cisco VoIP phone. It’s pretty amazing technology and I hope we get to see more and more Software to Device integrations in healthcare.
Device to Device – I actually can’t think of any device to device connections that I know of today. I imagine there are some out there, but I can’t think of any that are really popular. With that said, I can see the day where devices are talking to devices. A simple example could be a medical device talking with your Smart TV. Your device could know it’s time to take another reading and so it could display that to you on your Smart TV. You could have the option to respond on the TV and the TV could talk to the device.
In some implementations, we already have a device talking to your smart phone. This will become even more common once we have things like near field communication (NFC) in all smart phones. Depending on how this is implemented, it could be considered a device to software connection, but could also land in the device to device.
Theses examples might not be a good description of what type of device to device integration we could see going forward in healthcare. I’m confident that creative minds will come up with some really fantastic device to device integrations in the future.