Interoperability in Healthcare Tech: What it is & Why it’s Important

What is Healthcare Interoperability?

Healthcare interoperability refers to the ability of two or more healthcare systems to share information with each other so that they can interpret and use it. The “systems” can be medical devices, computer software, mobile apps, and more.

The term was made popular during the American Recovery and Reinvestment Act (ARRA) in 2009, which was the first attempt by the US government to outline expectations for health information technology (HIT) to electronically exchange data.

Why is healthcare interoperability important?

Imagine if pharmacists and doctors were unable to share critical patient information between their offices to make a timely treatment decision – that’s one of the many reasons healthcare interoperability is important.
Potentially life-threatening scenarios aside, healthcare interoperability has also worked wonders in terms of making the industry more consumer-friendly and convenient.

Take blood sugar monitors for example – diabetes patients can simply prick their fingers and have their blood compared against the device’s database. No need to go to the doctor’s office or pay for expensive treatments.

The convenience that healthcare interoperability allows can also be illustrated by the recent COVID-19 pandemic. Due to evolutions in healthcare systems, inflicted patients were able to share physical symptoms and parameters via the cloud to reduce the spread.

What are the benefits of healthcare interoperability?

While the benefits of healthcare interoperability are too immense to fit in one article, we will mention some of the most notable ones revolving around efficiency, accuracy, privacy, and more. Some key benefits of healthcare interoperability are that it:

  • Increases the organization’s operating efficiency
  • Reduces redundancy in data entry and management
  • Prevents costly mistakes: medication errors, etc.
  • Promotes consumer involvement
  • Speeds up and simplifies research
  • Improves digital medicine by facilitating big data analysis
  • Adds financial incentives through Meaningful Use

Healthcare Interoperability Standards

There are five types of standards associated with healthcare interoperability:

  • Terminology standards
  • Content standards
  • Transport standards
  • Identifier standards
  • Privacy and security standards

Terminology standards in interoperability are exactly what they sound like: guidelines surrounding the vocabulary, codes, and classifications that can be used through the process of connecting two systems.

Content standards differ because they deal with the data inside of the document during the information exchange – not the ways in which the terminology is used.

Transport standards refer to how the message or document is formatted during the exchange. For example, Digital Imaging and Communications in Medicine (DICOM) allows for the transfer of medical images to be passed between systems.

Identifier standards simply revolve around how a patient or medical staff personnel can be identified within the system.

Privacy standards aim to protect an individual’s (or organization’s) right to determine whether, what, when, by whom and for what purpose their personal health information is collected, accessed, used or disclosed. Security standards define a set of administrative, physical and technical actions to protect the confidentiality, availability and integrity of health information.

Healthcare Interoperability Levels

Healthcare interoperability is broken down into 4 levels: foundational, structural, semantic, and organizational. These levels are differentiated by their function and purpose – whether to connect the systems, organize the data, interpret the data, or the processes for how interoperability is used with other distinctions in the organization.

Foundational

The foundational level of interoperability establishes the connection between two healthcare systems. Without it, healthcare systems would not be able to communicate with each other in the first place. Foundational interoperability allows it all to take place, but further levels of interoperability are required to process, gather insights, and ultimately gain value out of the connection.

Structural

Structural interoperability is the level that determines how the data will be shared from one system to another. It defines the format that must be used in order for the two systems to make use of each other’s data. Once the structural requirements have been defined, the systems can understand the data being shared, and the user can, too.

Semantic

The semantic level of interoperability is where healthcare-specific concepts are exchanged and interpreted between systems. It ensures that medical terminology, naming conventions, etc. can be shared and used in a way that works. For example, common resources at the semantic level are HGNC and SNOMED. HGNC is the nomenclature for genes and SNOMED is a general-purpose language with over three hundred thousand medical concepts.

Organizational

The organizational level is how healthcare interoperability is used at the highest level – through business processes, workflows, and standard operating procedures. Inputs from legal, social, and organizational components are required to ensure proper integration across the whole ecosystem.

Healthcare Interoperability Challenges

Budget constraints

As with most technological advancements, there is a cost that comes with adapting to healthcare interoperability. And while we know the benefits far outweigh the alternatives, investing in the necessary people, tools, and education to make it work is not always feasible. Healthcare technology is expensive, and outdated or struggling organizations may not be able to afford to get started.
Improving interoperability requires strong coordination between different organizations, regulators, and leaders as well as coordination within organizations. Regulators provide standards and rules for healthcare organizations to follow but organizations that want to be proactive about interoperability should consider creating a dedicated interoperability strategy and make interoperability planning a priority.

Outdated systems

This tends to go hand-in-hand with budget constraints, as organizations with outdated technology may have to invest even more to bring their tech stack up to speed. For example – they will have to modernize their technology before connecting their data. Once they have new systems in place, they will still have to invest it properly aligning with the standards of healthcare interoperability – so it can feel like a double whammy.

Not all organizations have the financial or technical resources they need to invest in the technical resources needed to build a truly interoperable system.

There may be some government grants available to update health records systems, so organizations should check to see if they’re eligible. Many cloud vendors also offer pay-as-you-go payment models that could make technical expenses more affordable and predictable.

Organization & coordination

It takes a village to build and adopt a modern way of managing your healthcare systems. Leadership, faculty, and patients must all work together to meet the requirements of regulatory agencies, act in accordance with the law, and ensure that all parties are comfortable handling their sensitive healthcare data.

Wide range of needs

There is a large volume of healthcare organizations that provide different medical services and require different data-sharing protocols. Organizations may use different internal and external systems than their counterparts based on their specific needs and the volume of patients they serve. This can lead to increased complexity when adopting a more integrated approach.

Healthcare Interoperability Resources

Health Information Exchange (HIE)

Health information exchange, or HIE, allows us to move clinical information between two or more healthcare systems in a way that retains the meaning and use of the information. In doing so, HIE makes it faster, safer, simple, and more effective to transfer this information between entities.

Fast Healthcare Interoperability Resources (FHIR)

Fast Healthcare Interoperability Resources (FHIR) was created by Health Level Seven International (HL7) and is a “standard describing data formats and elements and an application programming interface for exchanging electronic health records.” Simply put, FHIR was created to make it easier to transfer healthcare data between systems.

FHIR organizes and structures data and provides guidelines for how they should be organized and interpreted by other computer systems and applications.

See the whole list of interoperability standards and resources here.

What is CCDA? Everything Your Product Team Needs to Know

What is CCDA? Everything Your Product Team Needs to Know

Within the healthcare industry, interoperability, or the ability of computer systems or software to exchange and make use of information, is of the utmost importance. It is imperative that patient data and records are able to flow freely between multiple providers, payors, and patients. In order to facilitate this process, CCDA, or Consolidated Clinical Document Architecture, was introduced as the standard for generating clinical documents. 

So, why is it important for product teams to know about this standard? Understanding the ways in which your software product idea can integrate into other systems will improve efficiency and function while providing a competitive advantage in the industry. 

What is CCDA? 

According to the official ONC website, a CCDA document is an Extensible Markup Language (XML) document summarizing current and pertinent historical information about an individual patient’s health care record at a given facility. Its primary function is to standardize the content and structure for clinical care summaries. 

To better understand the function of C-CDA, let’s start by diving into just CDA, without the “C”onsolidated part. CDA or Clinical Document Architecture, is a popular markup standard for electronic healthcare documentation. Each time a patient has a visit to a healthcare provider, a separate document is generated following this CDA format. Now, when you think of how many visits an individual has to make throughout their lifetime, there could be hundreds of these documents to exchange and sift through. As a result, CDA became known for having many variations, increasing the difficulty of exchanging these documents. 

In an effort to resolve this issue and improve interoperability within the healthcare industry, C-CDA emerged with stricter rules for the structure, encoding, and semantics of clinical documents of CDA documents. 

Benefits of CCDA

CCDA is a universal sharable health format that all certified EHR vendors can read and write, making electronic health records more easily exchangeable. Before CCDA, providers were put in a frenzy each time they tried to implement a specific clinical document. CCDA structure provides an easy exchange model for medical documents with better readability and point to point connection. 

CCDA benefits include: 

  • Facilitate user-friendly readable templates and information 
  • Allow caregivers to know where to go for the information they are specifically looking for 
  • Supports video and audio interoperability between systems 
  • Supports the exchange of clinical documents between those involved in the care of a patient.
  • Supports the re-use of clinical data for public health reporting, quality monitoring, patient safety and clinical trials.
  • Can be reused in multiple applications.
  • CCDA is a full-blown CDA, providing methodology for the templates in your electronic health record software.
  • Accommodates all medical documents, and may include binary data and other document types.

Limitations of CCDA

While they’ve helped to standardize EHR documentation, CCDA documents still have a reputation for being potentially hard to work with and hard to search. In fact, CCDA is being phased out for a newer format, FHIR, but it still remains highly popular among the healthcare industry. You cannot ignore it! 

Why is CCDA important for product teams to know about? 

CCDA format is important for product teams to grasp in order to formulate a product idea and optimize its functionality. You need to know what ways your software can integrate with other systems in the industry and how it will consume and exchange data within those systems. 

CCDA is essentially the means for which your product can communicate with these other integrations, as it is the most popular way for healthcare products to communicate with each other. Having your software comply with the CCDA format is a must when it comes to the healthcare industry.

Successfully Launch Your Healthcare Product in 6 Steps

Successfully Launch Your Healthcare Product in 8 Steps

If you’re a health tech visionary looking to bring your healthcare product to market, you’ve come to the right place.

Successfully launching a new healthcare product can seem daunting with the industry’s compliance regulations, codes, and security standards. However, it’s not much different from launching in any other industry.

In general, the attributes of a successful product launch in any given industry are similar. You’ll want to make sure you cover the basics whether you’re launching a complex health tech product, simple SaaS tool, or consumer product:

  • Start with the right people, resources, and expectations
  • Define and then focus incessantly on the specific problem or “job to be done”
  • Head to the drawing board for brainstorming and design thinking
  • Conduct rapid prototyping with regular consumer feedback
  • Land on a minimal viable product (MVP) after sufficient iteration on the prototype 
  • Conduct “mini” launches and continue to iterate as you go

Critical Healthcare Product Compliance To Consider

While bringing a product to market is similar across industries, there are some nuanced considerations to be aware of when it comes specifically to healthcare technology products.

Here are a few things to consider when building and launching healthcare products:

 

  • Data is sensitive for the healthcare industry, so there are often strict rules related to data security, data access, and data display.
  • There are various codes, regulations, and standards to consider like HIPAA, HL7, and CCDA that may impact your healthtech product. .
  • Interoperability –  – the ability to exchange and use information between two or more different healthcare systems. Much research has been done to conclude that interoperability in healthcare greatly improves positive outcomes and benefits for patients, and this should be something your healthcare product strives to maximize. 

1) Pick your product team

You’ll want the perfect mix of people to form your product team, from design, engineering, sales, marketing, subject matter experts, and customer success specialists. There are 4 primary risks that must be managed and mitigated when developing software products. Each of these areas should be assigned to a member of the product team whose primary role is to manage and mitigate the associated risk:

 

  1. Value Risk – will customers care? Will customers need/want/buy it?
  2. Usability Risk – will it be easy to use and ensure a frictionless experience?
  3. Technical Feasibility Risk – can the product be built with our time, skills, and money? Ensure someone owns the security and any healthcare-related regulation/compliance risks as well.
  4. Business Viability Risk – will the solution work for the various dimensions of both the product development company’s and the end customer’s business?

 

Ideally, this team will be assembled from people with previous product launch experience, as well as a mix of skill sets and backgrounds including graphic and UX design, engineering, sales and marketing, core business financial success stakeholders, and subject matter experts.

2) Define a clear, specific problem that is worth solving.

Without solving a problem that plagues the day-to-day lives of your target audience, you’re destined for failure. 

 

The best way to identify the specific problem you will be solving with your product is to think of your persona in terms of their “jobs to be done.” Examples of daily responsibilities may include painful data entry, tedious administrative tasks, or patient management.

3) Brainstorm solutions to your user’s problem.

This is the fun part – hitting the drawing board with your team. Once you have clearly defined a primary pain point within a job to be done, you can begin engaging in common brainstorming activities:

 

  • Host whiteboard sessions with your team to begin getting all of your ideas out of your mind and into writing.
  • Split up the team into smaller groups (or work individually) to sketch out ideas that might help solve the problem. 
  • Work together to narrow down the proposed solution to just one per member of the team (or just one per smaller group)

4) Decide.

At this point there will be several proposed ideas. We must now decide on one with which to move forward.

 

Here, the product team  deliberates over the landscape of proposals, and finalizes the one to be prototyped. Each participant or small group will share their one identified solution, and the full product team will engage in decision-making exercises to decide the final solution that will be pursued.

5) Begin rapidly producing your prototype.

Because of uncertainty, rapid prototyping is one of the best ways to begin gathering feedback from your target end-user. 

 

You’ve probably heard the phrase  “fail fast” – What this means is that you want to quickly understand whether your assumptions are right before continuing to apply them as you iterate through product development. Developing a quick prototype of the solution is one of the best ways to solicit feedback from your target audience, and provide them the opportunity to help adjust the design and development path. 

 

It is important to think of the prototype as something you will throw away, and only build into just enough structure and complexity to validate assumptions with your target audience. It needs to be real enough to solicit an authentic response from the user but does not need to cover every contingency or experience flow.

6) Validate and iterate.

Put the prototype in front of real users, and get their feedback. Adjust the prototype based on this feedback and repeat this process until the solution has been validated.

7) Develop an MVP from a validated prototype.

A minimal viable product or MVP, is a production-ready asset ready to launch commercially to your target marketing audience.

 

Here are some important points to know about MVPs:

 

  • The MVP is defined and built based on all of the feedback you have received on your prototype up until that point in time.
  • The “M” in MVP means “Minimum”, and should be underscored for importance. The MVP should be the simplest, least feature-rich product possible to satisfy a hyper-specific need of the market.
  • Stay away from the “feature trap” – adding unnecessary bells and whistles to a basic product that already solves a problem. Don’t build anything in addition to what you NEED to solve the problem..
  • As you proceed to build your MVP, focus on tackling the hardest challenges first.  For a health tech product, this may have to do with healthcare industry requirements and constraints, so having that subject matter expertise is imperative.

8) When to launch?

No amount of testing is going to prepare your product for real-world users. 

For this reason, it should help to look at your product launch as a series of small product exposures to the end users – as opposed to one big major event. Try to identify a small set of end users that will help test the product during development, and provide the kind of continuous feedback needed to ensure a successful product. Then slowly open this up to a larger and larger group. It’s better to roll the product out slowly than “launch” it all at once to everyone.

Launching a healthcare product is never easy…

Changing the “status quo” of the healthcare industry is one of the hardest things about launching a health tech product. 

Healthcare professionals are notoriously busy and lacking in advanced technology skillsets. There is also a loud market out there – with hundreds of software solutions to vet through.

Throughout the process, make sure to ask yourself and your team questions like: 

  • What are the most painful jobs to be done in healthcare today?
  • How is it done today? Does it work well?
  • What are they doing in their daily lives?
  • Why do they do it this way?
  • What could make this process easier for everyone?
  • How can we make a big enough difference to actually consider making a change?

ViroReact’s New Feature is Exactly What We’ve Been Waiting for

ViroReact is a react based Augmented and Virtual Reality product, allowing for easy native development for both iOS and Android. This is a huge win for developers looking to deliver an experience without all of the bloat that can come from builds using a full game engine like Unreal or Unity.

We’re currently working on a VR project for a client that’s provided us with the opportunity to dive a bit deeper into ViroReact. We’ve been impressed with with just how easy and flexible development with React has been for such a large set of features.

 

ViroReact Capabilities

Viro offers VR specific features like a 360 degree stereoscopic video player, interactivity options like gaze triggers, and the ability to render objects in real time.

For AR, Viro’s focus has been on surface mapping (ensuring objects stay in one place in the real world), advanced rendering (realtime lighting and shadows), and interactivity (clicking, dragging and dropping objects as well as “portals” allowing you to step into 360 images or videos).

The gaping hole in the solution’s functionality has been image/marker recognition for triggering rendered objects in AR experiences; however, in the latest release, this functionality is now available for both Android and iOS…and it’s looking pretty impressive.

 

Image Tracking Demos

Viro’s demo projects feature a Black Panther movie poster and the Tesla logo as example image triggers. These demo gifs are entertaining but also provide excellent insight into the sophistication of the technology.


Notice in the Black Panther example how the rendered model remains totally stable as the person walks in front of the poster. This environmental tracking stability is one of the most impressive aspects of the Viro platform, so it’s great to see that it extends to image tracking as well.

In the Tesla example, the user is able to click to choose the color option of the rendered vehicle and is an excellent example of a practical interactive use case.

 

What This Means for You

Impactful, multi-platform AR and VR experiences have never been within closer reach. Whether you’re looking to add something memorable to your event, show off your product in a novel way, or simply build a tool to aid internal processes, we’re here to help craft the right solution for you, leveraging the latest in cutting-edge technology.

How Leap Motion is Evolving AR Interaction

We’ve written previously about the future of everyday AR wearables and the how integrating them aesthetically into societal norms is the key to adaptation; however, in the world of commercial applications, this constraint doesn’t necessarily exist.

Instead high levels of functionality are demanded and with it the ability to intuitively interact with the technology in a way that adds real value without being cumbersome.

Leap Motion is leading the charge in the intuitive interaction space. Their first product, an infrared scanner intended to transform your hands into controllers within Virtual Reality. It was honestly impressive, and we’ve enjoyed integrating it into some of our Labs experiments.

Now, Leap Motion is bringing this same hand-tracking technology to AR with their new wearable Project North Star. Though it looks like something straight out of a sci-fi film, North Star is expected to sell for as little as $100 and will bring Leap Motions infrared tracking to the AR wearable. The initial demos of the project look very promising and we’re excited to get our hands on one to experiment with in the Lab.

With Project North Star advancing the world of AR and HTC’s Vive Pro pushing VR to the next level, 2018 is shaping up to be huge LEAP forward for Augmented and Virtual Reality.

HTC Vive Pro for VR | What You Need to Know

HTC’s new Vive Pro is officially available for preorder (ships April) and promises some exciting new features. This upgrade will really up the game in Virtual Reality headsets. At SeeSaw Labs, we’ve been using HTC’s Vive for more than two years now, and have been eagerly waiting to see what an upgrade would bring.

We’re looking forward to HTC’s continued innovation efforts because they communicate a true understanding of how to overcome the friction that can exist for new-users and commercial applications. Delivering a comfortable, intuitive experience is the key to continued VR adoption.

This new upgrade brings significant improvements in screen resolution and overall audio experience, as well as some very cool integration support features. Here is the skinny on each:

Better Resolution
The first big change is an upgrade to the screen resolution. It’s now in 3k with a 37% increase in pixels per inch. This should remove any feeling of the “screen door effect” and really contribute to overall immersion. This improvement will also increase in-experience text readability, potentially opening to door for greater commercial applications where larger amounts of text may be necessary.

Integrated, Spatial Sound
HTC has also simplified audio for Virtual Reality. Their integrated headphones also offer a bit more structure to the unit, allowing the user to simply put on a single device, with everything ready to go; if you’ve ever tried to find and put in earbuds with a VR viewer on your face (or even better a client’s face), you’ll instantly see the value here.

Best Feature, Isn’t Pro Specific
The most exciting announcement is the addition to the Vive Pro is wireless capability, set to release later this year. While 3rd party devices have cropped up to support this feature, they are very expensive and often quite bulky. The Vive Wireless Adapter is an exciting step forward towards improving the overall immersion of the experience. We believe this feature will be especially helpful in making first-time users’ experiences feel more natural (especially in commercial applications). Note that the Wireless Adapter will work with both the new Vive Pro and original Vive models!

Other Updates on the Way
Support for extended play areas, obstacle identification, and multiple players in the same space bring further cool opportunities to commercial applications, allowing for innovative, guided experiences. More accurate tracking can be achieved through linking a multitude of lighthouse sensors. This will provide for a better environment to support virtual objects that have real world counterparts.

Bottom Line
The Vive Pro is a big step forward. It’s finally delivering the type of experience everyone hoped for when first imagining virtual reality. We believe that this push forward towards a more “put it on and go” type experience (no headphones or cords to worry about) will allow for more innovative experiences and our clients to more easily put the technology to use.

Find out more about the Vive Pro from their official site.

Virtual Reality and Architecture

As with any emerging technology, successful early adopters are able to answer the question, “What can this technology do that was previously not possible?”. Virtual Reality is no exception, and successful initiatives deliver on this question.

What is VR Best At?
One of VR’s greatest strengths is its ability to communicate depth and scale. Have you ever visited the Grand Canyon or Niagara Falls? Videos and photos never do these spaces justice as they fail to communicate the sheer size and depth of these wonders. By the same principle, the best photos, architectural renderings, and videos cannot fully capture the experience of physically being present in a space.

Our Experience
As we built our environment for the Virtual Park we witnessed this effect first-hand. No matter how we manipulated the 3D models on our 2D screen, it was always more effective to view objects through the Vive headset. We often found ourselves, headset on forehead, toggling back and forth to make sure the width of a bush or height of a tree made sense spatially.

Opportunity Building on Existing Technology
In real estate development, architectural renderings have become a norm. Software like AutoDesk’s Revit and 3DS Max have made transforming AutoCAD drawings into simulated (sometimes even photorealistic) images easier than ever before. The opportunity then lies in finding a way to transform those existing Revit or 3DS Max files into AR or VR experiences.

How We Can Help
At SeeSaw Labs, we have experience developing AR and VR experiences for Mobile and High End devices using both Unity and the Unreal Engine. We also have experience working with the AutoDesk suite of tools (one of our partners was previously a Civil Engineer!).

There is no one-size-fits-all solution to creating impactful, value driven experiences, so our approach is one of collaboration and long term partnership. Our aim is to set up a workflow that can easily take your existing materials and transform them

Asking the Right Questions
When deciding what type of AR or VR project might be right for you, it’s helpful to know the right questions to ask to ensure that you’re getting the biggest impact for time spent. Here are a few to get you started:

Which devices will you be targeting?
Will this experience target Mobile devices (client download, for example) or will you be demonstrating with a high end device (HTC Vive, or Oculus Rift)? Your project goals will help answer this question. Keep in mind that interactivity and quality may be limited by the target device.

What level of quality is right for the project goal?
Are you looking for photorealism or are simple textures and lighting enough to communicate what is needed (see screenshot for example of the latter)? We can help you find the right quality level for your budget and needs.

How much interactivity is expected?
Simple teleport style navigation is often all that is desired (and can be achieved on mobile with the Google Daydream!); however, we are able to create more complex interactions like picking objects and map style teleportation (for large spaces). Let’s get creative!

Will this solution be aiding your design process internally?
For clients that find the VR experience particularly useful as part of the design process, we can help you set up an in-office device to include as part of your workflow.

Left: Design file from Google Sketchup Right: Virtual Reality representation with basic texturing and lighting (no internal lighting)

Rockstar VR Experience

Let’s Rock.

We made a virtual rock show to test the boundaries of what your phone and Google Cardboard can handle. Our crew is equipped to bring your virtual experience to life—be it an immersive 360 video or full simulation.

Rockstar VR - App StoreRockstar VR - Play Store

No Cardboard? Watch the 360 Video Here.