December 5, 2021

Utilizing FHIR to build a centralized patient’s Clinical Data Repository for better personal care service


In the not-too-distant past, getting the full picture of patient history for an in-home care service provider or emergency care provider was practically impossible, as most data was in siloed systems, and data exchange between these systems was challenging. However, the recent introduction of services leveraging HL7® FHIR® standard by cloud service providers fueled the adoption of FHIR-based data exchange – making data storable across all care settings, which can be seen as a sudden change in pursuit of interoperability.  

With the Interoperability and Patient Access final rule (CMS-9115-F) having come to effect in March 2020, there is much talk about FHIR across the industry, with the buzz causing interesting developments in the field. The new rules reorient the healthcare technology promoting a ‘patients first’ approach, with the primary focus being the streamlined flow of data to the patients, giving them (and healthcare personnel) the opportunity to be more informed, and will go a long way in expediting unnecessary burden and costs. In short, FHIR will be the next-generation standard by which electronic medical records (EMRs), digital health products, and patients use and exchange structured healthcare data.  

A Reliable Healthcare Cloud Platform 

Experion’s Healthcare and Life Sciences team recently built a Clinical Data Repository for a leading provider of home and community health care services in North America.  
 

With over 100 locations across the country, including home care offices, pharmacies, and infusion clinics, the client has more than 13,000 staff members and provides care to over 350,000 clients. They are dedicated to enhancing the quality of life, dignity, and independence of all their patients by providing customized care plans and solutions that allow the patients to remain in the comfort of their own homes. 

(Clinical Data Repository (CDR) is a database that consolidates patients’ clinical data from various clinical sources to present an aggregate view of a single patient).  

Utilizing “The Azure API for FHIR®,” a Platform-as-a-Service (PaaS) that allows upload, storage, management, and analysis of healthcare data in the Fast Healthcare Interoperability Resources (FHIR) format, an FHIR-based Clinical Data Repository was created that made working with Protected Health Information (PHI) in the cloud much easier.  

Some of the characteristics of the CDR are: 

· Enterprise-grade, FHIR®-based endpoint for data access and storage in FHIR® format. 

· SMART on FHIR for mobile and web implementations. 

· Control on data at scale with role-based access control (RBAC). 

· Audit log tracking for access, creation, modification, and reads within each data store to meet security standards like HIPAA. 

The solution eliminates the need for investing in resources to build, run, and maintain FHIR services and enables care providers to leverage the power of clinical data. The CDR has become the primary ‘source of truth’ that sits on top of other systems and allows standardized data in the FHIR format. This helps to enable data exchange across multiple systems, including analytics, with a consistent data format. 

Use cases and challenges of an FHIR service 

As the FHIR standard expands and continues to garner more adoption across the globe, more use cases will evolve. Though they seem infinite right now, many of these use cases can be seen as the first strides in removing some of the major hurdles that limit healthcare providers from accomplishing greater patient engagement, developing fine health management systems at a large scale, and leveraging technology to mete out more intelligent clinical decisions.  

 A few use cases that can also be seen as a trend are: 

· Third-party SMART on FHIR compatible apps that can be launched within, authenticated, and integrated with EMR/EHR Systems. 

· FHIR Façade for legacy healthcare systems that speaks FHIR in front-end and directly talk to the backend in native data. 

· Digital Health products and Healthcare IoT products leveraging fully managed FHIR cloud services as backend. 

Yet this is not to say that FHIR interoperability comes with no challenges. In fact, one would not be wrong to wonder why the adoption rates of FHIR are so slow, despite the system presenting a slew of hitherto unseen solutions. One of the reasons is that even large organizations struggle to match their existing domain to match the FIHR’s concepts, effectively operating as a shock to the system, unsettling the current balance and causing problems in realizing the desired benefits. This means many healthcare operators will need to ramp up their digital infrastructure, which may not be economically feasible every time.  

 Healthcare providers must show a great deal of resilience and must attempt to uplift their digital whereabouts to suit the needs of tomorrow’s technological solutions.   

To learn more about how you can utilize FHIR on your project, talk to a Healthcare and Life Science expert at Experion today.  



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