By Fred Donovan

November 19, 2018 - Major tech companies, like Google, Amazon, and Microsoft, are increasingly partnering with health IT vendors to remove barriers to healthcare IT interoperability.

In a letter released recently by ITI, these companies, along with IBM, Oracle, and Salesforce, “jointly committed to removing barriers for the adoption of technologies for healthcare interoperability, particularly those that are enabled through the cloud and AI.”

The tech giants have pledged to support open standards, such as Fast Healthcare Interoperability Resources (FHIR) standard developed by the Health Level Seven International (HL7) organization as common data standard to promote interoperability.

Last week, Microsoft released on GitHub its open source FHIR Server for Azure. “FHIR Server for Azure empowers developers with software that fully supports exchange and management of data in the cloud via the FHIR specification,” explained Microsoft Healthcare General Manager Heather Jordan Cartwright in a blog post.

“Microsoft is contributing this open source project to make it easier for all organizations working with healthcare data to leverage the power of the cloud for clinical data processing and machine learning workloads,” she added.

In addition, Google and CareCloud recently formed a technology partnership under which CareCloud will leverage Google Cloud’s healthcare API to accelerate expansion of its cloud platform with a focus on data interoperability.

The partnership is delivering interoperability to ambulatory care practices to drive real-time data sharing for patient-doctor shared decision making, explained CareCloud.

“The thing that Google is trying to do that we found appealing is they are trying to tackle big common problems, like interoperability,” CareCloud CTO Josh Siegel told HITInfrastructure.com.

“For example, it doesn't really serve the industry well if everybody goes out and builds their own implementation of FHIR. That's the opposite of what would be helpful,” Siegel related.

Google’s support for the FHIR standard is “something that's really appealing to us, not just because it helps us focus on the things that we find important, but also it becomes a common technology that everybody else that wants to be able to take advantage of interoperability will use,” Siegel said.

“If you look at the FHIR format, it originated with an in-patient delivery focus,” said Siegel.

“The big hospitals and big health systems wanted to exchange data with each other and insurers. They were the big advocates. If you look at a lot of the machine learning training data that's out there, it’s geared towards research institutions and large hospitals and health systems,” he observed.

By contrast, CareCloud’s partnership with Google focuses on out-patient and ambulatory care scenarios.

“Having that variability of input will help drive better machine intelligence down the line. We can do more than just talk about interoperability; we can start to put things into providers’ and patients’ hands much faster,” he said.

Healthcare's Need for Cloud Computing

When a healthcare organization gets to a certain scale and CIOs are running large distributor organizations, cloud computing becomes essential.

“Cloud gives you all kinds of additional guarantees in terms of availability and scaling, which really matter when you start aggregating these very large datasets, which is the center piece of interoperability,” said Siegel.

“If you think about the cloud, everything moves to APIs and that's what the healthcare API is trying to do. It is not just about storing data in a standardized interoperable way using the FHIR format, but it is about being able to access it in real time using a scalable set of APIs that are based on cloud best practices,” he noted.

An average health system wants to know that the infrastructure that its EHR is running on is up to the task. If the system has hundreds of providers operating out of hundreds of different locations, it needs scalable secure cloud infrastructure for data sharing. The providers need to have access to data everywhere, that's where cloud computing can help.

“We're all trying to improve outcomes and deliver higher quality care. The things that cloud did very well in the first wave is to take things like infrastructure, networking, and scaling, and make them ubiquitous and inexpensive,” Siegel said.