IoH: The Internet of Health
What is the Internet of Health?
October 2021
The Internet of Things (IoT) is an IT industry term describing a system of interconnected devices such as servers, desktop computers, laptops, smartphones, watches, and more. It has become a part of not only our vernacular as a society, but of our everyday lives. While other industries have benefited greatly from the IoT, the healthcare sector is yet to take full advantage of this latest technological revolution. One of the most obvious reasons preventing healthcare from joining the revolution was a lack of a standard data format. But things are finally changing here, thanks to FHIR making good on the promise of interoperability and paving the way for the Internet of Health (IoH). Soon, devices, systems, and networks that communicate seamlessly with each other across other sectors and specializations will realize their full potential in the medical arena.
1. FHIR will deliver the Internet of Health
Health data interoperability is not a new concept. In fact, it has been a common goal amongst healthcare providers and developers for decades. Despite many advances in medical technology, to date, the promise of seamless, on-demand and real-time information exchange has yet to be realized. Finally, the FHIR (Fast Healthcare Interoperability Resources) standard is ready to make good on this promise to reshape the healthcare sector.
What is FHIR and how will it deliver?
The inherent potential of the internet was not realized until a universal standard was developed, allowing stakeholders to share information seamlessly, across platforms and systems, in real time. That standard was TCP IP. For healthcare, that standard is FHIR.
Today, healthcare’s capacity for interoperability can be likened to the early stages of the internet; awaiting a standard that will successfully bring together disparate systems with the ultimate goal of i mproving healthcare for patients, providers, and practitioners alike. FHIR, unlike previous attempts from other standards, has reached a stage of maturity that warrants widespread adoption, thanks to its incorporation of each of the key characteristics of a successful standard:
Dynamism: Able to adapt to new iterations without disrupting its fundamental nature, FHIR is a dynamic standard rather than a static one. Changes and updates can be proposed to the FHIR standard without damaging or disabling existing implementations and instead, expanding those in meaningful and valuable ways.
Real-world references: Rather than demand that users conform to a rigid set of perspectives, FHIR enables them to reference objects in real-world terms; providing greater freedom and ease of adoption.
It is a Search API: Using technologies that align with the way we use the internet today, FHIR allows for the seamless exchange and broadcasting of information. What’s more, developers can access the FHIR spec to deliver applications specific to the value they’re looking for.
FHIR is a peer to existing systems: A fully-fledged peer to other health data systems, FHIR provides developers with the tools required as well as the capacity to access, update, and send information to the FHIR system.
A universal solution: Standardized APIs mean that any new application can be utilized by other FHIR users. As such, an application written specifically for hospitals may be used by other hospitals, for example.
Appropriate authentication and authorization: Armed with the mechanisms for authentication and authorization, FHIR allows developers to define who can gain access to data, what data specifically they can access, and under what conditions.
Free from restrictions to legacy systems: Whilst using the latest standards, FHIR does not restrict users to a legacy system, thus allowing users to update to the relevant standards as they change, whilst encouraging consistency of development.
What is the business case for FHIR?
The already widespread adoption of FHIR should not be attributed solely to its technological capacity. There is also a strong business case to be made for payers, practitioners, and developers. Business factors contributing to the success of FHIR include:
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A strong political push from both the USA and UK, including rules issued by the CMS and ONC, and the extensive use of FHIR by the NHS
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Clear market motivations including the ability to do real-time analysis and build valuable applications
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A broad acceptance that forward momentum is well overdue in the healthcare sector
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Payers, providers, researchers and integrators are united in their appetite for collaboration (best illustrated by the Da Vinci and Argonaut projects and their development work on implementation guides and use cases)
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Simplified systems thanks to fewer applications offers consistency and removes the need for users to operate dozens of applications
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Allowing for patients to be a part of their own healthcare team through engagement with their providers and payers, thus making better healthcare decisions
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Reduced healthcare costs thanks to better informed patients means reduced business costs for payers and providers
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Using devices such as mobile phones, tablets, and computers means meeting people where they are at, for greater engagement from patients
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The capacity for remote patient care means improved healthcare outcomes and reduced costs for payers and patients
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FHIR ‘Profiles’ alongside a broad standard allow developers to restrict the FHIR spec to their specific clinical application without losing functionality
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FHIR has the ability to capture not only health data, but incorporate administrative data such as billing–thus bridging the gap between payer and provider data
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FHIR does not require users to update to the latest version, and as such, users can make decisions about upgrades based on value-add potential rather than obsolescence
Ease of use, advanced functionality, and the already broad acceptance it is experiencing across the healthcare sector mean FHIR is primed to bring the Internet of Health to the industry.
Full article: FHIR and the Promise of Interoperability
The most successful businesses, in the formative years of the internet, were not those who continued to constrict information to company-specific silos, but those who collaborated on systems for the benefit of all. The Internet of Health will result in similar stories of success for those who work together to develop systems that work together for the advantage of the sector as a whole.
Why do we need collaboration in healthcare?
Members, whether incidental visitors to their emergency department or long-term chronic illness sufferers, are likely to encounter a variety of unaffiliated organizations throughout their healthcare journey. This results in inconsistent, incompatible and often inaccessible healthcare data, and means not only a greater strain on providers and payers but often poorer outcomes for patients. Collaboration through interoperability in the healthcare sector means better decision-making, more prompt and timely care and intervention, better health outcomes and enhanced value for payers and providers.
FHIRBall is facilitating essential collaboration in healthcare
The FHIR Business Alliance, or FHIRBall, represents a group of companies that have come together, committed to building truly interoperable solutions for the healthcare sector, based on FHIR. Although often competitors these members understand that their collaboration assists in promoting the adoption of FHIR throughout the sector. With a shared focus on the successes of their respective clients, this alliance will bring improved outcomes for patients, reduced strain on the healthcare system and better results for vendors. FHIRBall’s collaborative efforts mean that true interoperability will soon finally be achieved and that the IoH can at last realize its full potential.
Full article: The Internet of Health: Why Collaboration Matters
3. How to avoid obsolescence in healthcare
Although the need for healthcare will only grow as our population does, the sector must not become complacent about the threat of obsolescence. In fact, obsolescence should be a major factor in decision-making throughout the industry, as technological advancements continue, and the Internet of Health quickly becomes a reality.
Healthcare is soon to be turned on its head
In its simplest form, healthcare is a face-to-face interaction between patient and care provider but this is soon to be turned on its head with the arrival of the Internet of Health. Putting the client at the centre of their healthcare journey, the IoH aims to revolutionize the way payers and providers interact with their members/patients, for better outcomes across the board.
There are many reasons why currently the patient is one step removed from their healthcare journey. Whether it’s a lack of understanding, limited resources and siloed data and systems or all the above, patients feel excluded from decision-making and in many cases are unaware of vital information and resources that are available to them. With the advent of FHIR and the impending IoH revolution, these limitations will soon be a thing of the past. And, as preventative healthcare benefits everyone, it’s no surprise that we are seeing keen interest from stakeholders throughout the industry.
With devices already playing a huge role in the everyday lives of people today, and the COVID-19 experience showing us how understaffed and under-resourced our healthcare sector is, members are more than ready for the internet revolution. Players who hesitate to adopt the new standard will be quickly replaced by those willing and eager to participate. And there will be plenty of them.
From remote healthcare appointments which reduce the burden on doctors and hospitals, to preventative healthcare driven by devices, the Internet of Health holds enormous potential for the public (which constitutes the healthcare market in its entirety). Providers and payers who adopt early will be readily embraced by the market and will undoubtedly emerge victorious.
Avoiding obsolescence means embracing the changes ahead
If there’s one certainty in business, it’s that for every business reluctant to adopt a new service offering or capability, there is a competitor ready to take its place. The healthcare sector is no different and we will soon see the separation of the dynamic from the stationary in the Internet of Health race.
Avoiding obsolescence as a payer or provider requires:
- Gaining access to the comprehensive information available through the IoH, through the FHIR standard
- Using this data to more effectively diagnose, treat, and prevent illness in patients for better health outcomes
- Developing stronger relationships with clients/patients through enhanced engagement offered by the IoH, by interacting with them on their devices, providing preventative medical services, and offering remote healthcare solutions
- Building trust and loyalty from members/patients by providing them with valuable services from FHIR’s forthcoming applications
- Becoming an integral part of members’/patients’ lives by offering easy-to-access healthcare services, so that healthcare becomes a proactive activity rather than a reactionary response
- Diversifying service offerings and revenue streams, thus avoiding the pitfalls of a gradual shift away from in-person hospital, doctors, or specialist visits
- Embracing technological solutions for better management of revenue, site traffic, in-house patient experiences, and more
The Internet of Health presents clear benefits for members in terms of an enhanced level of control over their health and healthcare. However, the business case for payers and providers is equally strong. Not to be seen as simply an exercise in avoiding obsolescence, the FHIR standard offers both providers and payers the opportunity to diversify their services offering through new capabilities, deliver greater value to their clients, and exercise a greater degree of control of their revenue streams.
Full article: Avoid Obsolescence as Healthcare Technology Advances
4. Why we’re building the Internet of Health
There’s no doubt that the healthcare industry needs to change. In terms of organizing, storing and sharing data, little has improved in the sector for many years. As if to emphasize the point, the emergence of COVID-19 has brought into sharp relief the need for a rethinking of patient interactions, the use of resources and the sharing of data.
Unfortunately, for many industry stakeholders, technological advancements and IT tools are viewed as cumbersome and restrictive–an administrative burden that only interferes with patient care. That is why the FHIR standard together with the FHIR community are so crucial to the future of healthcare. Offering - for the first time - a truly interoperable solution with the potential to scale, FHIR is facilitating an Internet of Health that will revolutionize the sector. It will not only improve patient outcomes, but also improve outcomes for providers and payers.
Why it’s up to the FHIR community
Building the Internet of Health is simply not possible without widespread collaboration and broad adoption of a new standard. The rub lies in the fact that adequate engagement from the sector requires this uptake to be driven by a realization of the value provided by the standard, and not simply a mandated adoption.
Achieving the level of engagement necessary for the success of the IoH requires a community of like-minded players to support the concept and assert the merits of heterogeneity and diversity in the creation of capabilities. That’s where the FHIR community plays a vital role. By encouraging healthy competition amongst members, the community is building momentum for the IoH revolution and supports a solid framework for the exchange of information and ideas. The true competition is not between players, but lies in the status quo.
How will the FHIR community build the IoH?
For FHIR to succeed where other standards have failed, the FHIR community must find innovative ways to leverage this standard, always keeping in mind the fundamental principle of collaboration. Some of the ways the FHIR community is promoting the building of the IoH include:
Implementation Guides: Much like RFCs in the young years of the internet, IGs and the communities that are responsible for them have the ability to propose extensions to the standard. To date, the most widely adopted FHIR IGs, including the US Core Data for Interoperability, the Da Vinci Project's IGs, and the CARIN Group’s Blue Button IG are all communities built on processes, infrastructure and testing methodologies pioneered by the broader FHIR community. Going forward, we will see countless IGs rolled out and implemented, which will result in a huge variety of products being built around them for both clinical and administrative healthcare applications.
We at FHIRBall are united behind the common cause of the Internet of Health revolution and together with the FHIR community are actively invested in facilitating the IoH’s potential to deliver value to the wider healthcare sector.
Full article: Why We Need to Build the Internet of Health
5. Smile is bringing you the Internet of Health
Due to the complex nature of health data, amongst other factors, healthcare has lagged behind other sectors in adopting web-based technologies. With the emergence of FHIR, however, this is set to change, and it will be quite soon. So, how does Smile fit into the equation of bringing the Internet of Health to the world? Here’s how:
Smile is building out our user experience: In building out the applications that deliver value across all factions of the healthcare sector, we aim to support the industry to realize the true value of the IoH. Allowing for anyone to take advantage of numerous IGs, as well as the countless hours of thought, work, and expertise put into developing interoperability for healthcare through the FHIR standard, Smile is bringing the Internet of Health to the world.
Our expertise, capacity, and close partnership with FHIRBall and the FHIR community mean nobody is better positioned to bring the Internet of Health to our users. From managed solutions to our open-source platform; from our capacity for ever-growing volumes of data to our cloud service offering; from our thought leadership to our expertise; Smile is helping to bring about the healthcare revolution, to create a better healthcare system for all.
Full article: How Smile Digital Health is Enabling the Internet of Health
6. What do changing consumer expectations mean for healthcare?
Consumer expectations shape the future of all industries, including healthcare. And whilst healthcare has traditionally been a reactionary sector, catering to health events as and when they arise, the tide is turning on this equation. Consumer expectations are set to dictate the sector, and there are several important drivers for these changes:
Technology is driving expectations: Consumers continue to expect more and more from their devices, and healthcare players should be prepared to ride the tide of shifting expectations and be at the ready with integrated devices, on-demand information, flexible communications, deeper engagement, and enhanced technology-driven services.
Access to information is king: In the information age, where consumers expect information at their fingertips, the healthcare sector must derive value from healthcare data for the benefit of their clients. From improving both their immediate and long-term health through enhanced decision-making, to communicating directly with payers for billing enquiries, clients will soon expect to be at the heart of their own healthcare through greater access to information.
Access, trust, and autonomy: As the Internet of Health begins to provide an accessible pathway to greater longevity, consumers will become more heavily invested in proactive healthcare decisions. Not only do payers and providers need to cater to this need, they must also be prepared to back their services with demonstrations of reliability, integrity, and anonymity of the data where necessary. Building trust in your services means participating in meaningful communication and interactions with patients and members; offering them added value, demonstrating accountability and reliability, and providing greater autonomy over their healthcare decisions.
Risk-versus-reward in terms of privacy: It is widely understood that consumers are distrusting when it comes to sharing their information, and yet, paradoxically, are more than willing to forfeit their privacy and personal information when a technological solution is deemed to provide adequate benefit. Navigating this risk-versus-reward ratio will be key for healthcare payers and providers, and a core component of this is patient-mediated access. Patients who determine who can access their data and how, and who download healthcare applications for these purposes, are more likely to deeply engage with not only the applications, but by extension, their payers and providers as well.
The Internet of Health revolution is upon us. With the advent of the FHIR standard, and the support of FHIRBall and the FHIR community, the healthcare industry is primed and more than ready for this modernization. With the principal goal of enhancing the healthcare sector at large, for better outcomes not only for patients, but for payers, providers, researchers, and more, the Internet of Health is the long overdue answer to transforming the sector around the globe.
Full article: Changing Consumer Expectations Will shape the Healthcare Sector
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