As healthcare continues to become more digitized, data-sharing technologies such as application programming interfaces (APIs) are becoming key to enhancing clinical decision support and a more efficient and enhanced user experience, according to Tressa Springmann, CIO at LifeBridge Health.
Ms. Springmann oversees information technology, telehealth and the health information management functions at the Baltimore-based health system. Since joining LifeBridge Health in 2012, she has participated in the health system's pioneering support for APIs and Fast Healthcare Interoperability Resources (FIHR), a data-sharing standard used to facilitate easier electronic access and exchange of clinical data.
While LifeBridge Health has rolled out various FHIR and API initiatives both with vendor partners and independently, Ms. Springmann said the industry "still has a long way to go" before the standards are used industrywide.
Here, Ms. Springmann discusses her excitement surrounding the opportunities that come with leveraging data-sharing standards in healthcare and how technology can help enhance EHR workflows.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How can health systems enhance their EHRs to support quality care and efficient provider workflows?
Tressa Springmann: I am most excited about the opportunity ahead of us to use FHIR-enabled APIs to allow us to 'innovate around the edges' of our core systems. These standards allow for the best of both worlds: a standardized, supportable and optimized EHR for the organization and the ability to personalize for your users’ needs by specialty, and even by individual provider, through the low cost, easily maintained APIs. These APIs can make a difference around clinical decision support and even enhance security by keeping our protected health information local. This new open standard approach catalyzed by a maturing national data exchange network will allow safe access to clinical data by the providers and ultimately, I believe, the patients in our country.
Q: How has LifeBridge Health tapped into tech opportunities associated with APIs?
TS: There are several initiatives we've done at LifeBridge Health early on to demonstrate our pioneering support. We were one of the first 10 hospitals in the U.S. to implement the FHIR API to connect our patient portal to the Apple Health app. Our organizational portal is visible for any of our patients and consumers who also elect to be able to see that through their Apple Health app. We've also partnered with two vendors to support data exchange between their two systems using FHIR for patient scheduling thereby giving choice and finally as excited about some in house development around patient wearables, among others.
Our organization thinks of our core EHR, enterprise resource planning and customer relationship management systems as mature; they need to be treated as a very key asset but also differently than those endeavors that we want to take a little risk and innovate around. I think that APIs give us that capability of personalization. For example, we can all be on a standard EHR, and if any one of our pediatricians wants to use a different FHIR API-enabled growth chart, we have the ability to personalize that in a way that doesn't require a huge, heavy lift of maintenance and to take our core IT teams away from their standard EHR. So, there's a lot of excitement around that.
The industry still has a long way to go. How to develop the technology, using the standards and making sure it's not blocked for economic reasons are all very key to us being able to quickly move and implement these standards.
Q: As healthcare becomes more data centric, what guiding principles do you have in place at your organization to ensure data is used ethically?
TS: I appreciate that legislation helped us get EHRs adopted. But if we step away from that, what it means is that the clinical information on patients is really being pushed out from the inside of healthcare organizations. What I really envision is five, 10 years from now, it's really just going to be the opposite. We as consumers are going to be empowered (due to technological advances) with our healthcare information and then in real time and in a secure way, we can make that information available to care providers who are in our trusted circle. I know we have a long way to go because that's not at all how the industry has evolved, but we've got to start with trust. Health information for the population we serve is sacred and, as such, deserves our community to keep it secure and do make sure that our use of it is understood and agreed upon by our patients.
I'm overwhelmed by the sophistication of some of the security tools that we're starting to see. It's very exciting because it's not one size fits all; a lot of it has to do with actual clinical content. I'm also thrilled consumers are really starting to understand how important it is to protect this information. I think that's also complemented by our population. There are a lot of poorly held beliefs about going digital, but there isn't really a digital divide — there's quite a spectrum of comfort across many different age groups. But as individuals who grew up in a digitized world start requiring more and more healthcare, I think we're going to have a real revolution of more creative ways about navigating this balance between access and security.
Q: As CIO, what are some of your top priorities?
TS: There are so many layers to that. From an industry perspective, the status quo mode of operating is at risk of being displaced because we have not proven that we can effectively manage the cost of care down. IT needs to play its part here. It all comes down to higher quality at a lower cost. When we think about where American healthcare has been spending money, there have been so many studies that show we're spending it in the wrong places such as outdated and confusing administrative processes. As a result, it makes it hard to develop and keep a strong, solid, good bench of technologists. We know as we continue to digitize healthcare that if we don't do it from within, it's going to be done on the outside and be influenced differently. I'm not saying this is wrong, I'm just saying it could happen and, in fact those of us from this industry need to openly embrace the learnings and advantages our peers in other arenas can bring
Q: Anything else to add?
TS: Even in the chair where I sit as the CIO, we have got to start doing a better job around clarity to digital, using telehealth and reimbursing for it and leveraging artificial intelligence — at least initially in the form of robotic process automation — to create our own capacity instead of just asking for funding for more things. We need to challenge ourselves to find ways that we can continue to reinvent healthcare from the inside out by creating efficiencies for our clinicians, and our IT staff and our patients: creating that headspace that allows our team to also be able to focus on more innovative initiatives and not just keeping the lights on. It’s certainly an exciting time.