CONTRIBUTOR
Co-Founder and CEO,
Medplum

Over the last ten years, financial services have shifted from centering around traditional banking institutions to providing digital-first solutions. This is known as the “marble to code” transformation. 

Fintech innovations from the last decade include new ways to pay and borrow with services like Affirm, online banks like Chime that provide early wage access, investing from your phone with apps like Robinhood, and even the gig economy which might not seem fintech-y at first but depends heavily on new financial infrastructure. These developments have opened doors for people who had little access before—like those without credit histories, or who didn’t have easy access to banking or securities.

The change is not just about what is delivered to the consumer, it’s about beefing up the tech that makes all this possible such as APIs that set up bank accounts, check IDs, automatically check compliance and streamlining processes.

Health care will be the next industry to go through this transition – from “bedside to bytes”. New business models in health care are emerging that focus on keeping people healthy rather than just treating them when they’re sick, such as the expansion of home care and remote patient monitoring. For example, messaging a pediatrician from your phone and getting quick responses will soon become the norm, like what you see at Summer Health. This mirrors how Robinhood made trading stocks easy from an app. 

And, the similarities don’t stop there. The health care evolution, just like finance, isn’t only about what is delivered to the consumer, it’s about the behind the scenes technology and infrastructure. 

As IT professionals and developers look towards an impending health care evolution, the following are three things they must consider.

Protected Health Information (PHI)

Health data, per the law, needs to be carefully handled. For software professionals, understanding whether your application stack handles PHI, and protecting it appropriately is important. PHI is any kind of information in a medical record that can be used to identify an individual. If you do have to handle it, it is critical you build HIPAA (and or SOC 2, Type 2) compliance into your application in one of two ways. First, you can consider a compliance tool such as Vanta or SecureFrame. These tools help ensure the business applications you use, e.g. email or fileshare, are configured compliantly. Second, you can consider a Business Associate Agreement (BAA) application that manages your data. Handling PHI in a compliant way is a requirement per the law, and will be a requirement for many applications in the decade to come.    

Health Data Standards Literacy

FHIR and UMLS are standards for health data exchange required by government agencies, and learning the ins and outs of them is imperative as health care becomes digitized.  Both of these standards help increase quality of, and access to, care for patients by making data accessible to providers at time of care. FHIR is a data standard used to represent health care data, and UMLS are ontologies or codes used to represent categories of procedures, medical conditions, medications and more.

In addition to familiarizing your teams with these standards, it may also be useful to consider tools that support these standards when adding to your application stack.

Understanding Quality

Quality of care is very important, and can be tricky to understand in the health care context. There are special medical quality measures or “metrics” as measured by, for example, HEDIS or eCQM. It’s important for IT professionals to learn to capture data and create reports that measure quality specifically in the health care context.

For example, one of the measures that Center for Medicare and Medicaid services requires is screening rate – e.g. the percentage of women aged 50-74 who have had a mammogram in the past 2 years.  Designing a system that captures data like that and creates a report that’s correct can be a big lift, and applications are expensive to retrofit.  A basic knowledge of quality reporting  and which measures are related to your application is a long term timesaver. 

The future of health care is changing in front of our eyes, and with it how applications are built and managed in this heavily regulated industry. By familiarizing yourself and your teams with some of the standards and best practices, the road will be smooth for future innovation in health care.