Healthcare: Incremental Interoperability

I attended the innovative eighth annual Translational Medicine Conference

(http://www.c-tric.com/wp-content/uploads/2017/09/c-tric_conferenceprogramme_tmed8_v19w.pdf) this past week in Derry/Londonderry, Northern Ireland, an event hosted by the Clinical Translational Research and Innovation Center (C-TRIC). It offered a great collection of insights in different areas of medicine, focusing on ways to achieve actionable research and insights into effective changes in healthcare practice.

One of the most compelling aspects of this conference was the inclusion of the patient perspective in the form of video interviews of real patients talking about their experiences and perceptions of the healthcare system, personalized medicine, and what they understand about these topics. It was gratifying to find the patient voice included at the conference, and the feedback I heard from clinicians, researchers, and others was certainly very positive.

Transplant Patient Buddy App

But it was Dr. Conall O’Seaghdha’s presentation, “Transplant 2.0: Using Mobile Health Technology to Improve Kidney Transplant Outcomes,” that offered great incremental steps in facilitating the engagement of patients. Historically, at Dr. O’Seaghdha’s hospital, they had a paper-based “transplant passport:” a physical document that transplant patients carried around with them filled with their key data and information from the time they went on the transplant list through transplantation and afterwards.

Working with Patient mPower and with significant input from multiple groups (but especially patients), they developed the Patient Buddy app that was founded on the principles of the passport –  but updated for the digital age. The Patient Buddy app won the design IMSTA MedTech Awards for eHealth:

https://www.thedigitalhub.com/news/patient-buddy-transplant-app-wins-ehealth-award-2015/

This project had a focus on improving communication between the patient and case manager by helping manage the hospital’s workload. You can find more details on the app here: https://www.patientmpower.com.

The app includes a range of features directed at easing the burden on transplant patients, such as:

• Clinical data tracking
• Wireless blood pressure monitoring
• Improving adherence and reducing medication errors
• Enhancing the outpatient clinical encounter
• Patient education and changing behaviors
• Research

The data captured flows into the electronic medical record system used by the case managers, who can see the data as it is uploaded by the patients.

But it was the simple interoperability approach centered on laboratory results – that in hindsight, seems so simple – that makes this app special.

QR Codes

The quick read (yes, that’s really what “QR” stands for) bar code is a standard developed by Denso-Wave (part of Toyota) for labelling vehicle parts during the manufacturing process. They have multiple uses and can contain lots of different types of data. Depending on the type of data and error correction levels used, they can store up to 4,296 alphanumeric characters.

QR Code Interoperability

In the Patient Buddy app, in conjunction with the hospital system’s QR codes, reports of blood results are sent to the patient.

If the digital transfer of data takes place through one of current standards that exist, then there is no need to scan this result into the Patient Buddy app – but we are awash with reports of data blocking and challenges of sharing data between systems, and I love the simplicity of printing a QR code containing the data for a test and including a reader that allows the relevant information to be read and imported into the patient’s application.

Incremental Improvements for Sharing of Patient Data

We have no shortage of data, but so much of it remains locked away in the recesses of systems that are inaccessible to clinicians, patients, and their relatives. We have to liberate this data and provide easy access to patients, who remain the party with the biggest vested interest in the successful outcome of any intervention form the healthcare system.

Here are some incremental improvements we could apply to get us closer to free-flowing data and total healthcare data interoperability:

• Offer multiple methods to share data between systems
• Provide easy-to-use tools and methods to access and share data with patients
• Have patient data encoded into QR codes printed on all paper reports
• Empower patients with access to their data
• If in doubt, remember that augmented sneaker net (paper-based) document sharing works

Do you have any better suggestions for improving interoperability? What small changes have you seen that make a difference to speed up interoperability and sharing of data in healthcare? What one thing could we do that would have a big impact in this area?

Let me know.

PROGRAM NOTE: Listen to Dr. Nick’s first-hand account of his meeting in Northern Ireland today on Talk Ten Tuesdays, 10-10:30 a.m. ET. Register to listen.