Thursday, 28 July 2016

#Interoperability the Missing Link for #DigitalHealth Apps by @msharmas


In India we have 204.1 million smartphone users in 2016 [ http://www.statista.com/statistics/467163/forecast-of-smartphone-users-in-india/ ], it's only natural to find startups using the mobile as the way to acquire customers by providing mobile Health based products and services.

While it is a great way to provide accessibility and affordability of healthcare services via mobile health solutions, it is also important to understand the need to ensure interoperability of the healthcare data being captured in these apps.

Today we have apps for Diabetes Management, Appointments Scheduling, Continuous Monitoring, Remote monitoring, Activity monitoring linked with wearables, women and child health, cardiology, telemedicine, secure messaging apps, etc. The list in the past couple of years has really grown exponentially. And that is great, since the mobile phone has become the centerpiece device for most people.

One aspect seems to be missing in the Go-to-Market rush,
>>  INTEROPERABILITY !!

It reminds me of the scenario in healthcare regarding medical devices, which traditionally were never developed for the purpose of sharing data with other systems or outside the location they were placed. It just sufficed that they were connected to the patients and displayed the readings the doctor viewed during her rounds.

And I find the same happening with the DigitalHealth Apps.

I have been following some of the DigitalHealth Startups that have developed apps that cater to one specialty or another, and I have come across most of these mHealth apps to be trying to build in the feature-set, i.e., to be a patient's one stop shop for healthcare related data. In doing this they are duplicating the patient health record and there is a speciality-specific personal health record in each mHealth App (just like the medical device).

Since, each of the mHealth apps' provides a feature for the patient to upload and store their records, soon we will have more "silos of information" than ever before. Multiply that with the number of apps a single user might have on her phone for capturing one or the other healthcare related parameter, the problem compounds.


The problem of solving the interoperability of patient information will continue to be an area of concern.

Its therefore very important for the startups developing mHealth apps, to start the app development process by incorporating the Interoperability Standards in healthcare. I think this should be the first step in the app development process and in fact patients and the healthcare VCs, investors should demand the app to have the ability to generate interoperable medical records out-of-the-box. The question that one should ask before downloading and using an app should be, "Will I be able to share my medical data between apps, in a Standard and interoperable form?"

Quality & Interoperability

Just as there is no compromise on quality, there should be no compromise on interoperability

Take for instance the medical devices, no one insisted on interoperability, or the cost of enabling interoperability was perhaps higher than the cost of the machine, that no one went for it. It was perhaps thought, its OK, anyways the doctor goes on her rounds she will see the information

Similarly, today if we take a ‘share-it via app way’ out to interoperability, we will not have demanded for the "right way" of doing things, we would simply have been taking the same approach as before.

Interoperability should be a plug'n'play option and not a separate service that the vendor chooses to provide, if paid for. It should not be a "Optional”, or paid add-on.

Last i checked there were 100,000+ "medical apps" on the various app stores. How many of these are interoperable? If earlier we had to contend with medical devices that were not plug'n'play interoperable, today we have siloed data being created by mHealth apps.

Solutions to the Problem

The EHRs should have the ability to "add" apps data to the patient EHR allowing for incorporating the mHealth App Data into the patient's longitudinal record.

The app developers should consult doctors and capture "contextual" healthcare data of the patient. The app should have the ability to share this data via the HL7 certified, interoperable document.


Additionally, when a mobile user deletes a mHealth app from her device, any data stored for the patient should automatically be sent to the patient's registered email as a HL7 enabled document. Providing a summary and detailed medical record information of the patient. These should be downloadable into any EHR or another app. 

And there you go, its fairly simple and we look forward to you sharing your experiences with our community of readers. We appreciate you considering sharing your knowledge via The HCITExpert Blog
Team @HCITExperts [Updated: 29th May 2016]
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Manish Sharma
Founder HCITExpert.com, Digital Health Entrepreneur

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