Author: Duncan Weatherston
Author: Duncan Weatherston, CEO of Smile CDR
The Internet of Health has been many years in the making, as traditionally healthcare has lagged behind other sectors in adopting modern, web-based data exchange technologies, thanks in large part to the complex nature of health data. However with the emergence, acceptance, and broad usage of FHIR, healthcare is at last primed to transform itself from silos of disconnected data to an interconnected network of lanes. FHIR is receiving widespread adoption across the healthcare world thanks to its ease of adoption, functionality, and seamless alignment with the internet. So what does Smile CDR bring to the table?
Our platform is a community. Some customers start with our open-source product HAPI FHIR, the globally leading and reference implementation of the HL7 FHIR standard in Java. While others choose enterprise-grade Smile CDR for the enhanced capabilities, professional services, flexible deployment models, and premium support.
As the maintainers of HAPI FHIR, we at Smile CDR recognize the strength of the FHIR community and the value that can be unleashed by providing an open source library with every single FHIR resource for implementers around the world to innovate on top of. As a scaled international global good, HAPI is used to power public and private sector interoperability projects around the world, exposing it to a myriad of real world challenges and use cases which stress test and help drive the project’s development.
Smile CDR users gain access to a commercially supported product with the scalability, reliability, and performance that large organizations depend on. However, there is much more to the Smile CDR value proposition than simple access. As a first-class participant, thought leader, and leader in FHIR implementations, Smile CDR offers the expertise to allow for a deeper understanding of FHIR, a greater grasp on what it can achieve, and the foresight to plan for greater capabilities.
We’re here to bring the Internet of Health to the world
At Smile CDR, there are a number of ways we’re tackling the challenges of the Internet of Health. One way we are doing this is in building out the applications that can deliver value for healthcare, including providers, insurance providers / payers, clinicians, researchers, patients, and more. We are heavily focused on building out user experience capabilities and applications, to see the healthcare sector truly realize the value of the Internet of Health. The capabilities provided by these applications are going to be an essential characteristic of the Internet of Health, as they are designed to work on all types of infrastructure, allowing for anyone to take advantage of the many implementation guides (IGs) created, and the countless hours of thought and work that users continue to put into developing healthcare interoperability through the FHIR standard.
At Smile CDR, in partnership with the FHIR community (and in particular, FHIRBall), we are actively encouraging users to participate more thoroughly in the ecosystem, to drive more value from the applications being created, and thus derive more uptake and greater capacity for all of the Internet of Health. The Smile CDR platform facilitates communication between users and valuable players (such as enterprise customers in the community), to allow for the base of applications to grow, the richness of FHIR’s capabilities to grow, and greater value to be achieved from it. Smile CDR is an intrinsic component to creating applications of scale for our users.
Healthcare is catching up and Smile CDR is how you get there
In order for enterprises to add value to their users in the age of the Internet of Health, they must be able to deliver applications and data content. Smile CDR acts as an applications server, working in much the way that application servers did during the development of the internet. During the initial development of the internet we now know today, players worked together to build web servers and in turn, application servers. These application servers have a long and rich history in the internet landscape, and yet, the concept of application servers in healthcare is still a novel one. Smile CDR and its peers are at the forefront of this still-developing concept for the Internet of Health.
Application servers like Smile CDR mean that not only can users utilize FHIR to interact with and store information, but they can also exploit this data in countless useful and innovative ways, through configuration, customization, and code manipulations. At Smile CDR, we have built into our platform interceptors that understand how information is arriving, and give our clients the tools to be able to use this data in clinical applications; allowing for interoperability with diverse platforms and packages, as well as the efficient storage of the results, and the ability to make these available to others. What this means is, through Smile CDR, users are able to participate fully in the Internet of Health, and have tools at their disposal to deliver value to their own clients—positioning themselves as thought leaders and specialists in the healthcare community.
It helps to, once again, draw parallels to the internet’s development. The internet was created as a marketplace in which the wider community could view products and purchase them, Smile CDR is creating that marketplace capability for the Internet of Health. The internal marketplace of Smile CDR platform implementers also allows for the sharing of capabilities between and within teams.
The Smile CDR platform allows users to create capabilities, evaluate and enrich data, use predictive analytics, and develop integrated devices. Smile CDR gives users all the tools necessary to build a healthcare business that is aligned with the future of healthcare (including the distribution of capabilities and the federation of information), alongside a network of participating peers. Smile CDR is a primary player in this space for large organizations in particular, who struggle with huge quantities of data, and who need to integrate a wide variety of services and capabilities. Extending far beyond being a simple server for these organizations, Smile CDR is a service-driven company, providing the expertise to help clients derive greater value from the products we provide every step of the way. Smile CDR developers form an extension of our clients’ teams, helping with FHIR education, and standing up infrastructure through to solution design and implementation. Smile CDR also offers software licenses, services, and solution integration, alongside our own expertise and partnerships, to deliver scale for users in a cloud setting.
Smile CDR delivers scale through cloud services
The cloud is an essential component of the concept behind the distributed healthcare space. The foundation of this concept, and a key value proposition of the Internet of Health, is that data does not have to reside in any one place. Being a peer in the cloud alongside all other users allows for participants to instantiate in a way that is independent of physical location and potentially even independent of the cloud. With Smile CDR, users can deploy to multiple infrastructures, including cloud, on-premise,). Common data and request capabilities allow our FHIR platform to reside both in the cloud and on premises (or even using a hybrid approach) without compromising interoperability; even with a hybrid approach, one query works across all data sources.
Smile CDR supports these capabilities, giving our clients the flexibility to achieve their goals in the context of sharing data, while strengthening their data independence as they are not bound to the ancillary of historical infrastructure we are used to, such as servers. In this way, healthcare is going to soon catch up to other industries in terms of their adoption of the internet, and Smile CDR is the vehicle to that destination.
Smile CDR gives health data ownership to patients
Ultimately the internet, and by extension, the Internet of Health, is about the exchange of information between people. Smile CDR and FHIR are committed to facilitating that exchange of information for the benefit of the healthcare industry at large.
What the Internet of Health brings to patients is a channel of information from payers and clinicians that is both easily accessible and actionable in real terms. As the Internet of Health develops, and their FHIR capabilities grow, payers will increasingly be able to channel useful information to their members, through the devices that these members use most. This ability will inherently bind payers and their members in closer relationships, leading to stronger loyalties and better outcomes from a business perspective for payers.
What this means for patients, on the other hand, is control over their health records in a way that has not been possible before now. It will allow for the sharing of that data in new ways, and the ability for patients, their clinicians, and their health plans to participate in their care and interact with their health data in increasingly innovative and valuable ways—leading to better health outcomes.
Smile CDR will play an important role by creating a platform of capabilities for people to exchange information, interact with health information in useful ways, and interact with the system at large. Patients will be able to connect with specialists to share their health records and seek advice, as well as interact with trustworthy groups to obtain peer advice. What the Internet of Health means for the sector is a human ecosystem of healthcare recipients who have trust in the information they are receiving, and an incentive to derive maximum value from their healthcare. Smile CDR gives the healthcare sector the capacity to turn the historical healthcare strategy on its head.
This historical healthcare integration strategy has always involved a reactionary approach; when a patient gets sick, they seek out a clinician, who then deploys healthcare measures to improve the patient’s condition. What the Internet of Health proposes is that, by having a direct channel to patients, healthcare providers and payers have the mechanisms to flip this equation and interact with people more proactively, by keeping patients healthy, preventing negative health outcomes, and by having data available to all applicable healthcare stakeholders, including patients. This results in a health management strategy rather than a health remediation strategy, allowing for a more consistent revenue stream through more engaged patients who are willing to spend more of their income on maintaining their health. This brings about a thorough distribution of effort across the entire healthcare system, to improve the quality of healthcare delivered to patients, and ultimately, improve their health overall.
We all want to make the world a better place. Smile CDR’s mission toward this goal is to improve the world through better health data resulting in better global health. We’re facilitating the advent and expansion of the Internet of Health to make the world a better place in ways that go beyond simple clinical interactions. The possibilities are endless, for providers, payers, clinicians, patients, and all those involved in healthcare.
Smile CDR is breaking down information silos
The person-centred aspect of the Internet of Health is a compelling one. However, there is another aspect that Smile CDR is playing a key role in: the breaking down of information silos.
The internet allowed us to break down silos of information and make data and assets infinitely distributable. By using Smile CDR, our users are able to free their data and make it available to patients, clinicians, hospitals, and more, at the discretion of those who are clinically responsible for that data. The moment this information is made available to those who need it, the value it brings is increased. This information has value not only to the patients, payers, providers, and clinicians, but to the research community, the broader medical community, statisticians, educational institutions, government bodies, and more. The crux of the matter is that this information has not been unavailable until now because of patients’ or payers’ desires to keep it that way, but because there weren’t the structures in place to allow for adequate, efficient, and ethical sharing of this data. Smile CDR is facilitating the sharing of health data by creating the capabilities necessary for this sharing from each of those communities, including clinicians, medical systems, researchers, and more.
Anywhere there is an opportunity to participate in this ecosystem, Smile CDR is available to support our clients with tooling to help them migrate from their legacy infrastructures. We are set to become the platform of choice, as the backbone and enabler of many valuable downstream capabilities. In this way, Smile CDR is the spine that ensures information is universally available and that it is backed by the capabilities necessary to distribute and make use of that information.
The way that health information is stored and managed currently, namely siloed and inaccessible, is inefficient. The way forward in this upcoming poly-implementational environment is in being able to plug in and remove participants as necessary, while the information gathered continues to be persisted for consistency. As applications are added or removed from the platform, information patterns and capabilities will continue to be enriched. Smile CDR, in its vision and manifestation, enables users to cleanly participate, interpret, gain insights, and innovate, as healthcare improves thanks to the promise of interoperability. And, as the sector has so much catching up to do, we envision this contribution from Smile CDR will continue to add value for years to come.
And finally, where Smile CDR is particularly valuable is in the aggregation of the huge amounts of information from devices. As we look into the future, we see the early interfaces like smart watches and tablets being superseded by more advanced devices which act as remote telepresences, monitoring health, responding to changes in health (like changes in hormones, blood pressure, blood sugar, heart rate, stress, etc.), and acting on this information to deliver potentially life-saving and certainly life-enhancing support to patients. Eventually, we see the human body as a major source of health data, and the Internet of Health possessing the capacity to respond to that data proactively. The questions for the healthcare sector to consider are: Where is that data going to go? How are we going to manage that data? How are we going to make it available to applications? How are we going to ensure data privacy and security? And the answer is: Smile CDR.
The vast streams of information that are going to begin to arrive need to be categorized, managed, deployed, made available, and then used as a part of research and ongoing evaluations of population—all while safeguarding legal and ethical privacy boundaries. In keeping with our mission of better global health, Smile CDR will play a critical role in managing and making sense of that wealth of information. Ultimately, these efforts will deepen our understanding of human health at a fundamental level, especially when applied to fields like genomics. We at Smile CDR plan to lead the development and delivery of the Internet of Health in the pursuit of truly long-term health for all.
Read Part 2: Why Collaboration Matters for the Internet of Health
Read Part 4: Why We Need to Build the Internet of Health