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APIs take root as the path for healthcare interoperability

July 30, 2019

The healthcare industry is at a turning point. Patients and providers are eager for advances in value-based care, patient engagement, and machine learning as they look to usher in a new era of constantly-improving health outcomes and well-being. Interoperability is key to removing the barriers between the healthcare industry and the future it seeks to build.

Having a strong and continued commitment to data interoperability will offer faster data insights to improve patient outcomes, increase productivity, and reduce physician burnout. Our commitment to interoperability involves investment in our own products like the Cloud Healthcare API, as well as our contributions to the open source tools including Google’s FHIR protocol buffers and Apigee Health APIx, which will help developers embrace and implement these standards with ease.

We believe it is important to work with stakeholders across the ecosystem – patients, providers, insurers, researchers ,tech providers – to unlock important data and enable patients and their care teams to derive insights when it is needed most. 

Today, we are very proud to announce that Google Cloud is joined with Amazon, IBM, Microsoft, Oracle, and Salesforce in support of healthcare interoperability with the following statement at the Blue Button 2.0 Developer Conference at the White House.

Full statement below: 

As healthcare evolves across the globe, so does our ability to improve the health and wellness of communities. Patients, providers, and health plans are striving for more value-based care, more engaging user experiences, and broader application of machine learning to assist clinicians in diagnosis and patient care.

Too often, however, patient data are inconsistently formatted, incomplete, unavailable, or missing—which can limit access to the best possible care. Equipping patients and caregivers with information and insights derived from raw data has the potential to yield significantly better outcomes. But without a robust network of clinical information, even the best people and technology may not reach their potential.

Interoperability requires the ability to share clinical information across systems, networks, and care providers. Barriers to data interoperability sit at the core of many process problems. We believe that better interoperability will unlock improvements in individual and population-level coordination, care delivery, and management. As such, we support efforts from ONC and CMS to champion greater interoperability and patient access.

This year's proposed rules focus on the use of HL7® FHIR® (Fast Healthcare Interoperability Resources) as an open standard for electronically exchanging healthcare information. FHIR builds on concepts and best-practices from other standards to define a comprehensive, secure, and semantically-extensible specification for interoperability. The FHIR community features multidisciplinary collaboration and public channels where developers interact and contribute. 

We’ve been excited to use and contribute to many FHIR-focused, multi-language tools that work to solve real-world implementation challenges. We are especially proud to highlight a set of open-source tools including: Google’s FHIR protocol buffers and, Microsoft’s FHIR Server for Azure, Cerner's FHIR integration for Apache Spark, a serverless reference architecture for FHIR APIs on AWS, Salesforce/Mulesoft's Catalyst Accelerator for Healthcare templates, and IBM’s Apache Spark service.

Beyond the production of new tools, we have also proudly participated in developing new specifications including the Bulk Data $export operation (and recent work on an $import operation), subscriptions, and analytical SQL projections. All of these capabilities demonstrate the strength and adaptability of the FHIR specification. Moreover, through connectathons, community events, and developer conferences, our engineering teams are committed to the continued improvement of the FHIR ecosystem. Our engineering organizations have previously supported the maturation of standards in other fields and we believe FHIR version R4—a normative release—provides an essential and appropriate target for ongoing investments in interoperability. 

We have seen the early promise of standards-based APIs from market-leading Health IT systems, and are excited about a future where such capabilities are universal. Together, we operate some of the largest technical infrastructure across the globe serving many healthcare and non-healthcare systems alike. Through that experience, we recognize the scale and complexity of the task at hand. We believe that the techniques required to meet the objectives of ONC and CMS are available today and can be delivered cost-effectively with well-engineered systems.

At Amazon, Google, IBM, Microsoft, Oracle, and Salesforce, we are fortunate to work with many teams and partners that draw on experiences across industries to support and accelerate the delivery of FHIR APIs in healthcare. Moreover, we are committed to introducing tools for the healthcare developer community. After the proposed rule takes effect, we commit to offering technical guidance based on our work including solution architecture diagrams, system narratives, and reference implementations to accelerate deployments for all industry stakeholders. We will work diligently to ensure these blueprints provide a clear and robust path to achieving the spirit of an API-first strategy for healthcare interoperability. 

As a technology community, we believe that a forward-thinking API strategy as outlined in the proposed rules will advance the ability for all organizations to build and deploy novel applications to the benefit of patients, care providers, and administrators alike. ONC and CMS’s continued leadership, thoughtful rules, and embrace of open standards help move us decisively in that direction.

Amazon, Google, IBM, Microsoft, Oracle, and Salesforce

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