FHIR Open API

Catching FHIR with Alphabet and Apple

In the last few years, the landscape of healthcare IT has evolved, with interoperability at the forefront. There’s still a lot of work to go, but I’ve seen exciting progress recently. For example, companies who aren’t traditional healthcare IT players are bringing fresh perspective and building out solutions tailored to patients.

Some of their success depends on the seamlessness of connections with healthcare IT solutions already in place. As many companies have learned the hard way, there’s only so much replacement energy that the market can sustain, especially when touted new solutions don’t actually drastically improve the patient and provider experience. And it’s always a challenge to drive a drastically new approach.

So these new solutions have to work in tandem with what’s already out there. That’s where FHIR comes in—with widespread adoption and success, FHIR can be proverbial tinder for the growing fire of data exchange and interoperability.

The New Kids on the Block

The evolving connectivity of the healthcare market has provided huge business opportunities: for example, the positioning of Alphabet (Google), Apple, and Amazon (I call them the AAA of healthcare IT) for new healthcare products and services.

The AAA companies all have smart home devices: Alphabet has Google Home, Apple has HomePod, and Amazon has the very successful Alexa. So right now, the AAA are in a very good position to use their AI solutions with medical devices to support disease discovery (e.g., for mental illness, diabetes, COPD, or cancer) in people using their services. In combination, AI and medical devices can be used as screening tools or chronic disease management tools. They could also be used in conjunction with telehealth services by capturing current patient medical data in support of a telehealth visit.

Apple also just launched their Apple Health Records feature, which uses FHIR. The solution gives patient users visibility into their records right on their iPhone. Currently, data only flows one way (from provider org to patient phone), but providers look forward to a bidirectional data flow. While Google failed in their initial foray into healthcare with Google Health, that may improve their chances for success in the new market environment—failure is a good teacher in this industry.

How FHIR Can Help

The FHIR standard is well positioned to facilitate connectivity for the AAA and others in the industry. Alphabet and Apple have publicly committed to use FHIR as the foundation for communicating healthcare information from their solutions to providers. Imagine being able to have your medical devices (e.g., blood pressure cuffs, scales, pulse oximeters, etc.) connected to your smart home device, which then sends that information directly to your providers when captured or as directed by you. This could be especially powerful for patients with chronic conditions and could help catch medical issues early. And that helps everyone’s wallets, too, because late interventions tend to cost dramatically more.

FHIR provides key capabilities that help companies monetize their products and services, which is why I believe Alphabet and Apple hopefully will be very successful using FHIR in their healthcare endeavors. FHIR is designed to support web applications and cloud architectures for securely and easily sharing healthcare data. It also provides a standardized and easily implemented approach for capturing and sharing medical-device data. And FHIR can be tailored to fit with application workflows to support intuitive and efficient product designs.

The two major interoperability facilitators, Carequality (The Sequoia Project) and CommonWell Health Alliance, have also adopted FHIR as a foundation for their members to efficiently share healthcare information. These interoperability alliances will validate FHIR as a key communication architecture as they continue to facilitate information sharing among their members.

The last piece of the puzzle should be Stage 3 of meaningful use, which requires open APIs for health information exchange among providers. The final rule for Stage 3 does not specify FHIR as the API foundation, but I believe doing so would be the right move for CMS and the ONC—the adoption of FHIR by Alphabet and Apple minimizes the market risk in making FHIR the interoperability standard.

Any healthcare organization evaluating a clinical healthcare IT application should make FHIR adoption and its demonstrated use are keys selection criterion. Moving forward, the benefits provided through FHIR and other API toolsets will make healthcare all the more effective.