How Hospitals can Improve Workflows, Create Better Patient Outcomes, and Deliver Higher Quality of Care
You’ve probably heard a lot of discussion over the last few years about FHIR and healthcare APIs, and how these things have the potential to be a giant leap forward for achieving interoperability within healthcare. There certainly has been no shortage of excitement surrounding the new standard framework created by HL7. And to be honest, much of this hype is warranted, but how can hospitals actually take advantage of FHIR and healthcare APIs to improve workflows, create better patient outcomes, and deliver higher quality of care?
SMART on FHIR Apps Assist Clinicians with Daily Work and Educate Patients, Resulting in Better Outcomes for Patients
Hospitals such as Hackensack University Medical Center, a 775-bed teaching and clinical research hospital that is ranked nationally in 4 adult specialities, have been taking advantage of SMART on FHIR apps to educate patients and assist their clinicians with daily work. They have also improved several pieces of equipment in order to perform more detailed clinical trials, working with companies like Precision for Medicine that know exactly how these trials are performed. What is SMART on FHIR? The SMART Health IT website defines it as:
An open, standards based technology platform that enables innovators to create apps that seamlessly and securely run across the healthcare system. Using an electronic health record (EHR) system or data warehouse that supports the SMART standard, patients, doctors, and healthcare practitioners can draw on this library of apps to improve clinical care, research, and public health.
One example of an app that helps educate patients is the Duke PillBox app. The Duke PillBox app, developed by DukeHealth, aims to make it easier for patients to manage complex medication regimens. PillBox solves this problem through an interactive learning tool whereby patients drag and drop their medications, along with their prescribed dosages, into the appropriate time slot (i.e morning, afternoon, evening). The app is intuitive because it contains pictures for every pill and offers a “hint” button if patients are having difficulty remembering their dosages schedule. The goal of the app is to improve compliance and adherence results and is used as part of both the discharge process and in the patient’s home.
The Duke PillBox is an example of a SMART on FHIR app that is designed to educate patients, but the majority of the apps have been developed with a different goal in mind – to assist clinicians in their daily work.
Take the EnrG | Rheum app for example. This app allows rheumatologists to aggregate data in a clinical way and saves clinicians valuable time by collecting data from the patient about their wellbeing, via a questionnaire, prior to their visit. Essentially, the amount of time spent in the clinician’s office is reduced dramatically because clinicians do not need to ask questions such as: How you are feeling? Where is the pain? When did this start? What are your symptoms? The clinician has all of this information from the questionnaire prior to the visit. Another benefit of the app is that with the availability of this real time data, clinicians not only know how their patients are feeling on a particular day, but they can also plot those data points against prior data to track overall progress.
Furthermore, the app also saves time for clinicians because it auto-assembles about 90% of the clinic note for the provider; this note is highly organized and can be sent directly back to the EHR. The results of this app’s usage have been overwhelmingly positive so far as Geisinger Health Systems reports that with less time spent on chart reviews and documentation, clinicians at two sites reported a 26% increase in productivity over the course of a two-year period. Moreover, Geisinger claims to be saving nearly $1,000,000 each year with the app because it allows them to better manage expensive biologic medications.
The EnrG | Rheum app and Duke PillBox are just two of the 40+ SMART on FHIR apps currently available. SMART on FHIR apps are exciting for hospitals and clinicians because they add functionality that is not normally available in an EHR. If your hospital wants to take advantage of FHIR, you’ll need an integration engine that sits in between your EHR and the app to accept, receive, and transform FHIR resources. We’ll be highlighting the best and most innovative of these SMART on FHIR apps in a December blog post so check back with us then (or subscribe below and have our blog updates sent directly to your inbox twice per month).
Improving Hospital Communications and Workflows with Healthcare APIs
When people talk about FHIR, much of the discussion tends to centre around the REST API model, and rightly so. This is the shiny new toy that FHIR brings to the table: a more robust and formalized approach for a query-and-response method for exchanging healthcare data. Both public and private APIs can help help streamline many operations and improve workflow within hospitals.
Private APIs can bridge the multitude of systems used in hospitals today. For example, FHIR could enable various hospitals systems to access the same patient record from a vendor-neutral archive. Another private API could be developed for employees to help predict staff requirements more accurately, resulting in lower overtime costs. Healthcare APIs can also make it a lot easier to share data between internal hospitals systems and better facilitate record sharing between healthcare facilities; freeing up time for nurses to spend more time with patients instead of paperwork. What other APIs are available? Check out this list of 91 Healthcare APIs from the ProgrammableWeb.
Hospitals Taking Advantage of User Generated Data from Wearables and Mobile Apps to Deliver Higher Quality of Care
Devices for patient generated and controlled data have proliferated over the past few years. With the rise in popularity of mobile health apps, wearables, and mobile medical devices, patients have more data in their hands than ever before. But right now, all that data is being siloed into smartphone apps. Apple has healthkit for example, which is their way of collecting all this data and allowing developers a way to leverage that data into new applications.
In a way, FHIR is trying to do the same thing for EHRs. How would quality of care improve if a doctor had daily observations gathered from mobile apps and devices instead of once-in-a-while observations conducted at the doctor’s office? And what if we could harness all this data for analytics to enable new clinical decision insights?
Since all these applications speak the language of HTTP protocols, FHIR may be our best bet to integrate this data into the EHRs.
The Ochsner Health System was able to significantly reduce hospitalizations and decrease the blood pressure levels of over 500 individuals by having patients track their body weight and blood pressure with their connected devices. The data was then sent back to Ochsner’s EHR via an API and the results were very encouraging. By simply recording their own blood pressure once per week, over two-thirds of Ochsner’s out-of-range hypertension patients were within range in just 90 days.
Here at iNTERFACEWARE, we really believe in the potential of the FHIR standard. It’s why our CEO, Eliot Muir, threw his weight behind it over 3 years ago with his blog post, “what is FHIR and why should you care?”. It’s why the Iguana Integration Engine supports FHIR and web services like RESTful APIs right out of the box – no add-ons required. And it’s why we provide all of the tools and code necessary to help you implement FHIR projects as quickly and easily as possible. For starters, we have demo FHIR server and client channels that you can import form the Iguana web services repository. These channels will give you a strong foundation for building your own FHIR projects. Check out our step-by-step tutorial in our knowledge base to learn how to implement a FHIR server and client.
Interested in learning more about FHIR? Download one of the free resources below: