This week, Google announced the launch of its Cloud Healthcare API, which is calls a “robust, scalable infrastructure solution to ingest and manage key healthcare data types.” And during a keynote speech at HIMSS18 on Monday, Eric Schmidt, former executive chairman of Google, outlined his vision of a truly connected, fully AI-assisted learning healthcare system, and how cloud technology is a foundational building block to that.
“I’m going to start with, get to the cloud, run to the cloud. Take an airplane, fly to the cloud. Most of you sit in data centers that work on proprietary logic. We now have cloud technology available, from Google and others, that’s much safer than your data center, much more compliant than your data center,” Schmidt said during his speech to HIMSS18 attendees.
Allscripts CEO Paul Black also is bullish on cloud technology in healthcare: “There’s no question that the cloud is going to be a big factor in bringing down the total cost of ownership,” he said. “It’s something we’re focused on—Practice Fusion [an electronic health record platform] is cloud-based, many of our solutions are cloud-based. We recently put Sunrise into [Microsoft] Azure, so we’re actively moving applications to the cloud. There’s no question that in five years, 10 years, most of the applications that hospitals access will be cloud-based.”
In an exclusive interview with Healthcare Informatics Associate Editor Heather Landi at HIMSS18 in Las Vegas, Black discussed the company’s latest developments to incorporate machine learning into the EHR, interoperability efforts as well as how the Chicago-based EHR technology company is helping providers and government and public health leaders address the opioid crisis.
On Tuesday morning, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced a broad new initiative, called MyHealthEData, to empower patients to control their health data. In response to that announcement, Black said, “We welcome that, we encourage it. We have been talking about interoperability and open API (application programming interface) access for a long period of time. We’ve been doing that and offering that to our clients for the past 10 years.”
He added, “We think to have true interoperability you need to allow that level of access to the data, allow patients to have access and to pull that data out. We also believe, at the end of the day, that it’s the patient’s record and they should have full access to it.”
Black continued, “This dialogue is a natural progression of the digital framework as a result of the stimulus act in 2009 [American Recovery and Reinvestment Act]. The good news is, we’re all digital; the bad news, or the challenge is, we have all these different EMRs, we now have 400 different EMRs. So, interoperability, from my position, is a high-class problem. We have technically solved it, so let’s now talk about workflow and how to make that data that resides in different EMRs more usable to the clinician and more useable to the patient.”
Black also said that “intra-operability” or interoperability within vendor networks is not sufficient. “So how does Epic interface with Epic? While that’s interesting, it’s not enough. Epic has 15 percent of the marketplace, globally, therefore, 85 percent can’t connect to that. You have to be able to pull information out and harmonize that information. There is a workflow component that harmonizes the information and that’s a piece of the interoperability discussion, let’s talk about the harmonization of that data.”
Allscripts touts its open platform as well as its relationships with entrepreneurs and healthcare providers. In December, the company announced it hit an industry milestone of one billion API data exchange transactions in 2017. The Allscripts Developer Program (ADP) has certified 200 distinct applications and devices for its users, which are available through the company’s application store.
Black also addressed a blog post he wrote, which was published last Friday, criticizing a recent report from Orem, Utah-based KLAS Research examining interoperability efforts by CommonWell and Carequality. The vendor is an original CommonWell member—but has not yet signed up with Carequality.
The report, “Interoperability: An Inside Look at Plug-and-Play Patient-Record Sharing,” concluded that CommonWell Health Alliance’s interoperability services currently lack value. The report asserted that CommonWell's interoperability efforts are being hindered by a lack of provider adoption, but when CommonWell and Carequality eventually connect, “instant value” will be created for users, the KLAS report stated.
In his blog post, Black said the report looks at interoperability through a specific lens—connectivity through “plug-and-play” services—and he called that approach, “short-sighted and dangerous.”
Expanding on that blog post, Black said, “To me, in that report, KLAS narrowed the classification of what interoperability was. The definition was too narrow, it didn’t incorporate point-to-point interfaces, local health information exchanges (HIEs) and APIs. To us, those are a wider and more accurate definition of what interoperability is, versus a narrow definition of ‘Do you connect to a plug-and-play network?’”
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