LIVE! in Epic’s App Orchard

By David Genetti, President, Clinical Technologies


What a difference 8 months can make.  The healthcare industry and the global community are facing challenges that have not been presented to humanity in living memory.  As we emerge stronger, and recover from the loss, the new normal will be established. The ability to continue to improve global health for all through advancing technology will remain a strong component of that new reality. Last July I shared my thoughts on the future of healthcare, specifically focusing on the role of interoperability and the ability to liberate important, but potentially elusive data from the Electronic Health Record.  There is much left to be done to truly realize the power of the data that already resides in the systems of our healthcare institutions, but progress is definitely afoot!

I am thrilled to announce that we are part of a small group of companies that have been approved by Epic and are listed live in the App Orchard.  It is similar to some other App stores that you may frequent, with the exception that we needed to demonstrate deep and broad competence – clever images your teenagers want to share with their friends were optional. Not only did this process allow us to demonstrate our command of the data related to the practice of medicine in our field of focus, nutrition and gut health in premature babies in the NICU, but also a broad and comprehensive excellence in all healthcare information policies and procedures.  This review covered usability and accessibility standards, performance metrics, dedicated support and education commitments, data management practices and medical safety. Following our months of working closely with the team out of Epic’s headquarters in Verona, WI, incorporating feedback, establishing real-world test scenarios and satisfying hundreds of important criteria, our listing was approved and can now be found in the App Orchard:

So, what does this mean?  Approval to operate within the App Orchard environment unlocks and streamlines many of the traditional processes that need to occur for a deeply integrated solution like NICUtrition to be deployed live to users.  The standardization of the FHIR API messages dramatically reduce the burden on internal technology teams. The clear identification of the precise queries and data elements presents an easily understood project that requires little to no custom work from customers.  Authentication can be seamlessly implemented, allowing approval of access to identified sources of information through authorization standards. General comfort is gained knowing that we are all speaking the same language and translation is only required in fringe cases.  This allows us to collectively get to work solving novel and critical clinical challenges instead of reinventing the rules under which we will access critical information.  

Much as is the trend in medical practice, the ability to deliver scalable customized solutions starts with a strong commitment to standardization.  The standards establish the framework in which we all agree to work together. With these newly unlocked tools, we can build truly transformational applications.  Customization is now a powerful opportunity as opposed to an implementation nightmare. The ability to rely upon well understood and accepted methods of accessing and sharing nuanced data presents the opportunity to address countless “wouldn’t it be great if…” daydreams.  

In our world of preemie nutrition, we are making those dreams a reality.  NICUtrition is leveraging the full power of App Orchard interoperability. Detailed analysis of nutrition needs and the level at which they are being met is now possible at a resolution historically reserved for large, cumbersome and expensive retrospective studies.  Further, this level of detail is now available in real-time! There is clear value and achievable impact from deep access to current data for analysis.  Importantly this allows for immediate influence on care pathways for patients actively in our care, as opposed to discovering changes that could have been made for patients that have already been discharged.  This holds true at the department level as well as the individual level. NICUtrition provides powerful tools and visualizations that provide immediate indicators of unit performance as well as deep research and analysis capabilities related to feeding practices and outcomes, down to the individual nutritional component of single feeding events.

There is more work to be done, for sure.  The Office of the National Coordinator for Health Information Technology (ONC) in March finalized the proposed rule related to interoperability of Health information.  This is a major milestone in our collective efforts to continue to realize the promise of existing rules and regulations and legislation. There is the appropriate amount of excitement and consternation.  The timeline for compliance and the burden associated with compliance is meeting resistance from some communities. On the other hand, there is great excitement related to the ability for thought leaders to deliver new tools in a truly competitive landscape free of information blocking. Additionally, the ONC rule has established meaningful access directly to individuals through mobile devices and emerging platforms as a goal of the rule.  To a certain extent the usual players have established their positions, but under this rule, we are truly poised to unleash solutions that are only just now possible.

Astarte Medical is committed to true interoperability and we welcome the ONC rulemaking.  This is a forward-looking rule. The rule establishes Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) version 4.0.1 as the standard by which we will all interact as the rule is rolled out.  While this standard is not “new”, it is not in use as widely as its “older” siblings, DSTU2 and STU3. The most important aspect is that we have selected a standard and we can focus on our solutions knowing that we will be able to interoperate effectively.

With our listing in the App Orchard and a continued commitment to supporting and adopting interoperability standards, Astarte Medical remains poised to deliver on the promise of liberated data driven solutions for our most fragile patients.