At the HLTH conference last month, I had a chance to talk with Ricky Sahu, CEO at 1upHealth. For those not familiar with 1upHealth, the provide a FHIR platform for payers, providers, and developers. Whether you’re looking at CMS compliance, population health efforts, Payer to Payer APIs, or EHR connectivity, they can help make sharing data using FHIR a reality.
What I found interesting talking with Sahu was his observation that every company wants access to the data, but every company also wants to compete on the data. That’s a challenging dichotomy that I see over and over again in the world of health IT. I’ll never forget Jonathan Bush on stage back when he was CEO of athenahealth saying that there were plenty of other ways for EHR vendors to compete. EHR vendors didn’t need to compete on data. The reality however, is that almost every health IT vendor is walking this tight rope between wanting access to the data (ie. everyone should be sharing data with me) while also not wanting to share the data they have in their systems with others.
However, Sahu pointed out how a series of policy changes has really pushed sharing to become more of a reality today. Sahu first shared how regulations helped to create the supply of data. In this case, it’s easy to see how meaningful use and the HITECH act pushed EHR adoption on healthcare organizations. While we could discuss ad nauseum (and we have) about the weaknesses of EHR adoption and the challenges it presents healthcare organizations, it’s inarguable that at least now the data is being stored electronically in the EHR. The supply of data in EHR software today versus 10 years ago is like comparing an ocean to a small pond.
Moving beyond the supply of data, Sahu went on to point out that value based care has now created a demand for the data. It’s one thing to have the data available and another to actually have a reason to leverage that data. In a fee for service world, access to the data isn’t that compelling. In fact, many healthcare organizations were benefiting from not having access to the data so they could profit from the duplicate tests. However, in a value based care world that all changes and access to the data is essential to achieving your value based care goals. This is creating an incredible new demand for data that didn’t exist previously.
Finally, Sahu suggested that FHIR has been the catalyst for healthcare organizations to be able to share. I recently heard an interop expert say that it takes about a decade for a standard to reach maturity and then it’s used extensively. They used examples of CCDA and HL7v2. Considering FHIR development first began in 2012, we’re about to hit that 10 year mark where use of the standard generally explodes. FHIR could indeed be the catalyst to more information sharing in healthcare.
In fact, that’s this is the exact bet that Sahu and his team at 1upHealth are making. I was also interested to learn how he broke down the 1upHealth FHIR platform into 3 areas: connectivity, compute, and compliance. He believes that healthcare organizations are going to need a partner that can do all 3 and all 3 at scale. It’s going to be fun to watch this space and see if Sahu’s prediction is right and which companies will be able to embrace FHIR interoperability as it scales.