With analytics, healthcare can get more from its investments in FHIR
Analytics on FHIR is a real-world example of how applying open standards to healthcare data can help deliver near real-time insights for better care management and operational efficiencies in healthcare organizations.
By now, most people in the healthcare industry understand the purpose of FHIR (Fast Healthcare Interoperability Resources), a data-sharing standard for exchanging health information electronically. Why is FHIR important? Simply put: if you have two data sources, and you need them to “talk” to each other, FHIR can help accomplish that goal.
But healthcare organizations can get a greater return on investment if they go beyond enabling two things to talk through data exchange. Implementing a FHIR server or application programming interface (API) is often how organizations meet regulatory requirements, and is an important first step on the journey to interoperability. This effort can require a lot of resources – including financial, time and talent – and healthcare organizations should think beyond the mandate to get more out of this investment.
In my role as informatician at my hospital, I was part of a team asking the question: What more can we do with the FHIR healthcare data we’re exchanging? We had been working to connect several tools and were adding FHIR input/output capabilities to an EMR. That’s when we realized that FHIR is JSON, which is structured text. And we can analyze text at scale. That was a huge leap forward for us.
Traditionally, we would have to take healthcare data out of a database, standardize it and bring it into an analytics package to analyze it and produce a report. But we implemented a solution that streamed data to, and worked directly on, the FHIR server. Every time the EHR wrote to the database, it also instantly sent the FHIR resource that matched the record.
Not only was this approach helpful for tools that needed to consume this health information, but it had potential to vastly enhance our analytics capabilities. We used a text-indexing search engine for semi-structured text. Because the solution indexes information as it’s written, queries could go straight to the index – no coding required – enabling near real-time results with massive scale. This also obviated the usual database synchronization challenge between healthcare data sources and the analytics repository.
Here are just a few examples of how organizations can apply FHIR-based expanded analytics capabilities for population health and program performance:
- Find real-time insights. We could manage the healthcare provider clinic’s workload more effectively, knowing near real-time answers to questions such as: How many patients checked in today? How many are currently roomed? How many were discharged?
- Improve data quality. Another benefit of implementing a FHIR server into your healthcare data strategy is that it encourages good data-hygiene and standardization. Because FHIR requires validation against common standard to be interoperable, it lets you find deviations from the standard in your existing data pipelines.
- Address gaps in care. The server can help teams manage quality measures, cohort definitions and other tasks that help address gaps in care. Let’s say a clinician calculates a neuropathy risk score as part of the EHR workflow. A FHIR extension could add this health information to the patient’s record of visit.
- Integrate social determinants of health (SDoH). Understanding more about where the neighborhoods’ patients are coming from could help tailor population health efforts. Adding GPS coordinates of home addresses, and loading SDoH as extensions onto the FHIR server, can enable population-level analytics.
- Deliver insights at the point of care. Return those expensively created care metrics back to the point of care, rather than a report sitting in a file somewhere. Having risk scores and cohort information at the point of care provides a significant ROI for this process.
Essentially, FHIR servers can extend the value of the clinical and administrative data that healthcare organizations are exchanging. It can enable organizations to move beyond regulatory compliance and release constraints of a traditional approach, where analytics are confined in periodic reports. It can make health information more valuable to organizations on a daily basis.
Whether it’s a hospital, healthcare provider, payer or government agency, a robust FHIR server can deliver agreement on data format and then derive insights that can enhance clinical care and operations. The door is open to countless new use cases.