In search of a digital health compass

HL7, Chronaki
Catherine Chronaki, Secretary General, HL7 Foundation

The number of mobile health apps is skyrocketing. The European Commission has established a new working group to create some guidelines enabling health systems to safely connect to mHealth apps and a companion code of conduct for apps developers. Although the widespread use of the phrase “there must be an app for this” reflects the diversity and proliferation of such apps, when it comes to selecting the right app to address or solve a health problem, I often find myself at a loss.

If digital health literacy were defined as the ability to seek, find, understand and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem, when it comes to health apps, we have a big problem! After more than 30 years working in information technology, I am still a digital immigrant amazed at the ways kids - the digital natives - approach digital health!

A morphing relationship

The world is changing. The health professional-patient relationship is changing. For years, we have been discussing the notion of integrated care as the means to improve health and social care services in relation to access, quality, user satisfaction, and efficiency. There are mHealth apps that could help not just in diagnosis, but also in treatment, care, rehabilitation, and self-management. Can we find them? Can we trust them? Can we trust the search engine with our data? What kind of safeguards do we need to feel secure, attended to and safe online? Do we have the right standards in place to enable us to address the challenge of multiple apps tapping into our health data?

Don’t get me wrong! There is progress. The region of Andalusia in Spain is eager to set up the structures for assessment, monitoring and certification of third party apps that wish to interact and deliver services over their integrated health record infrastructure. The General Practitioner association in the Netherlands released an app “Should I see a doctor?” Medtronic and Watson announced the first diabetes app to take advantage of big data. Still, when I try to find an app for my particular health need, I am lost. In the United States, the first diabetes app can now be officially prescribed. Around the world courageous physicians and specialists are beginning to recommend apps for their patients to record their progress between visits.

In the underlying culture change, education is key. My suggestion would be to consider the possibility of using your own health data to search for apps, and learn about your own health issues.

My data, my decision, our ePower

Mobile apps can be seen as the cells in ecosystems of connected health systems. User experience and satisfaction is entrusted to those apps, but it is interoperability and quality standards that make the apps stick.

Can these interconnected apps help truly realise integrated care, bringing together inputs, delivery, management and organisation of health and social care services in a co-ordinated, seamless way? How? What are the steps we need to take?

Traditionally, when we think of standards, we picture large detailed documents that are vague and full of self-dependencies, resembling the monolithic systems of the past. Actually, standards are also affected by the change. You can think of standards moving in two gears - a fast one to meet today’s demands, and a slower traditional one. Can we link the two? This is the challenge Standards Developing Organizations (SDOs) are facing.

Constructing the compass

HL7 Fast Healthcare Interoperability Resources (FHIR) the faster gear takes the notion of the interface to the next level. HL7 FHIR is helping reinvent standards in a digital world constantly in motion and change. Can HL7 FHIR be the key to our digital health compass? Only time can tell… but HL7 enthusiasts around the world are working to make it happen.

As Secretary General at the HL7 Foundation, I’d like to invite you to join us, the European Federation of Medical Informatics and HIMSS Europe, at eHealth Week 2016, to discuss the concept of the digital health compass concept further.

We would also welcome your comments, ideas and feedback on this post. We look forward to hearing from you – and seeing you in Amsterdam in June!