SynapticHealth Overview

CONTENTS

Links to Key Articles
Glossary
Overview

LINKS TO KEY ARTICLES DESCRIBING SYNAPTICHEALTH

Getting Synaptic Promotes "Meaningful Use"

Get Synaptic: Strategies for HCIT Vendors

How Synaptic are your solutions & apps?

Synaptic Strategies for HIEs & RHIOs

I.T. Trends SynapticHealth is Bringing to HCIT & HIE

Synaptic Strategies: App Stores & Malls for Healthcare

o      Synapse and synaptic refer to the spark between brain cells that produces data, information, intelligence, an idea, a memory

o      Information Services are the processes that turn data into information and make information available via technology; web services are a subset of information services.   Information services can be everything from code and infrastructure (interfaces, transaction variants, adapters, EDI formats) to transaction processing services to applications (software, hosted applications, software-as-a-service/SaaS, Web 2.0 widgets/apps, etc).

o      Healthcare Information Technology (HCIT) – the clinical, financial and administrative information technology solutions in healthcare

o      Healthcare Information Exchange (HIE) – the “glue” between HCIT solutions (integration and connectivity, transaction processing, and governance/security/privacy/authentication)

o      Distributed network of disparate systems – this is what healthcare is – this is what HCIT and HIE vendors need to recognize whenever they try to embed their single solution into a distributed network of disparate systems.  How does your app co-exist in the eco-system that is healthcare, HCIT and HIE?

o      Information services exchanges are places where publishers, consumers and sponsors of information services can go to ‘trade’ in their services – download, subscribe, mash up, access APIs and SDKs, sell services through indirect channels, etc.  Think App Store for the iPhone, or Appexchange for Salesforce.com.

o      Publishers, Consumers, Sponsors, and Affiliates are the players in this form of commerce.  This includes B2B, B2C, B2B2C, Web 2.0, Health 2.0, etc. business models.  For example, and HIE may sponsor an information service that can exchange information between numerous publishing systems and consuming systems – and perhaps there are affiliates out distributing, reselling and/or connecting that service.

o      Mash-ups are combined information services built with scalable underlying technology (SOA, web services).  Mash-ups represent much of what healthcare needs from HCIT and HIE.  Think “bundled services” or “bundled apps” – e.g. at the point of service (POS) in the revenue cycle, provider organizations need bundled or mashed up services in order to check eligibility, perform estimation, and accept payment from patients – the more integrated the bundle of information services, the better the POS process.

o      Sales Distribution Channels are direct, resellers, value-added resellers (VARs), e-commerce, etc. – HCIT and HIE basically have direct channels – SynapticHealth expands the distribution of healthcare information services into Web 2.0 affiliate marketing and beyond

o      Forums, Directories and Social Networking are the Web 2.0 content management tools that let collaborators build a hub of activity.  Registries are directories of web services.  All of these are the components of an Information Services Exchange.

o      SynapticGrid is the Registry component of SynapticHealth, the portal for healthcare web services and mash-ups of those services.

Putting it all together, SynapticHealth is a hub of activity for publishers, consumers, sponsors and affiliate marketers of healthcare information services – and a place for all of HCIT and HIE to find better tools and services with which to better co-exist in the ecosystem of other HCIT and HIE applications. 

OVERVIEW

SynapticHealth is a platform for healthcare information technology (HCIT) & healthcare information exchange (HIE) consumers, vendors, and developers to promote and spark collaboration around information services - everything from infrastructure (interfaces and adapters) to apps and full-blown solutions.

SynapticForums: Discuss the means by which you publish and consume data; provide a place to spark mass collaboration around your apps and solutions

SynapticDirectory: List your companies Synaptic credentials including downloads, adapters, SDKs, interfaces, and other information services

SynapticGrid: Evolve your apps and services to web services, integration as a service (IaaS), and software as a service (SaaS), and then publish them on the SynapticGrid

Value provided by SynapticHealth:  Like Apple's iPhone App Store or Salesforce.com's AppExchange, SynapticHealth powered by the SynapticGrid is a means to develop a smarter, stronger and potentially lucrative distribution channel for apps and solutions - or, a place to find scalable, replicable, and efficient HCIT & HIE apps.  But it is also a place to begin to commoditize connectivity and transaction processing, the infrastructure components of interoperability, in favour of value-added information services that are scalable and replicable.

SynapticHealth seeks to improve healthcare, healthcare information technology (HCIT), and healthcare information exchange (HIE) by giving the market a place to find, discuss, buy and sell, and mash-up healthcare information services.

SynapticHealth is a Place to Find Information Services

Simple as this sounds, there is little to no ability to even Google search and find adapters, system interfaces, transaction variants, subscription-based services, etc.  Nor is there a place to find services that a CIO or developer knows will live in a particular type of environment. 

For the following services to become scalable and replicable, and to get commoditized in favor of value-added HCIT and HIE information services, SynapticHealth’s information services exchange is a place to list with high specificity

1)    Infrastructure – interfaces, transaction variants, the bits of code that let systems co-exist in the ecosystem of HCIT and HIE

2)    Transactional Services – Clinical, financial, and administrative transactions need to be updated (or, clearinghouses need to be disintermediated)

3)    Software and Solutions – As HCIT and HIE solutions move to hosted applications, Software-as-a-Service (SaaS), etc., these services need a distribution channel, and they need to offer the market tools for implementing the solution in a particular environment (e.g. adapters).

4)    Mash-ups and Value-Added Services – Once there is a place for services to co-exist, e.g. web-deliverable services, there will be a movement towards “mashing up” these services.  For example, hospitals want to connect directly to health plans (direct payer-provider connectivity) but there is not a place to go find and consume those transactions.  Once there is, providers will be able to combine eligibility, claims, remits, authorizations, etc. for more and more health plans in more and more valuable ways – and then share this capability or even the information services themselves with the market.

a.     Healthcare Needs Better HCIT and HIE: What healthcare really needs from HCIT and HIE basically does not yet exist in scalable fashion because of the limitations of HCIT and HIE infrastructure (specifically integration and information exchange).    

b.     HCIT and HIE Vendors Need a Platform: Vendors of HCIT and HIE solutions realize the difficulties associated with thriving in a distributed network, but there is not a place where they can publish and consume information services that give them an entrée into HIE, let alone a place where they can then combine their services with others to provide the services the market really needs.

SynapticHealth is a Place to Discuss Information Services

1)    Forums: SynpticHealth’s web site includes Forums where developers and others can discuss how to implement services, incorporate update technology into their information services mix, publish and consume services, find adapters, trade information on methodologies, etc.

2)    Professional Networking: This community also needs a directory of capabilities, and for the market to eliminate some inefficiencies, there need to be ways to find people and products that eliminate some redundancy (e.g. there are dozens of sites today trying to build the same interface from scratch – how can this development be shared?).

3)    Ratings, Comments and Awards: In this sort of Forum and Directory structure (via a Content Management System / CMS), services themselves can be discussed and rated by end-users.  Services can be ranked by popularity.  And SynapticHealth plans to have awards for the most popular, most connected, most interoperable, best mash-up, “most Synaptic” services.

SynapticHealth is a Place to Buy and Sell Information Services

1)    Alternate Distribution Channels: HCIT and HIE do not yet have viable distribution channels, in large part due to inefficiencies of the underlying technology (and also due to the process of setting an institution up to trade personal health information / PHI).  But as information services move to updated technologies that can be distributed via the internet and via affiliate marketing models, SynapticHealth will be the marketplace for these services.

2)    Grass-roots Marketplace for Developers:  As developers write code that they know is valuable in hundreds of other institutions, or as institutions pay for interface development, for example, they now have a sales outlet for these services.  For value-added services and mash-ups, the developer community now has a marketplace.

3)    Billboards for Professional Services:  Simply being able to tell the market what you have built in the past is a good value-add for the market.

 

SynapticHealth is a Place to Launch Mash-ups & Value-Added Services

1)    Healthcare Needs Better HCIT and HIE: What healthcare really needs from HCIT and HIE basically does not yet exist in scalable fashion because of the limitations of HCIT and HIE infrastructure (specifically integration and information exchange).    

2)    HCIT and HIE Vendors Need a Platform: Vendors of HCIT and HIE solutions realize the difficulties associated with thriving in a distributed network, but there is not a place where they can publish and consume information services that give them an entrée into HIE, let alone a place where they can then combine their services with others to provide the services the market really needs.

 Comparables and Analogies

What the AppExchange is to a single solution like Salesforce.com, the App Store is to a single device like the iPhone, Xignite is to a market vertical like financial services, or Google Apps or Widgetbox are to generic web services, SynapticHealth will be to all applications, devices, information exchanges, and data trading partners across the healthcare industry. 

Another analogy is a shopping mall for information services: where the App Store and Appexchange are individual stores in the internet mall of information services stores, SynapticHealth will be a mall of shops for all information services.  Every medical device should have an App Store; each electronic medical record (EMR), personal health record (PHR), hospital information system (HIS), practice management system (PPMS), etc. should have an Appexchange; transaction processors should have web services versions that can be embedded easily in other applications; and, then mash-ups of healthcare information services can begin to drive more value.

Examples of what SynapticHealth can do for a few key HCIT and HIE applications

o      Electronic Medical Record (EMR) or Personal Health Record (PHR): beyond the functionality of storing a patient’s chart, EMRs and PHRs are only as good as their ability to exchange information with other applications, and to live in the ecosystem of HCIT and HIE.  While you won’t hear this very often, Google Health recently heard this about their PHR product: their customers said “we want our data and we want more services” and they meant that their data lives in a lot of different places but it needs to be in their PHR, or their PHR needs to be able to publish and/or consume information services. Google makes APIs available and opens their application to the developer community for the purposes of adding HIE and information services capabilities.  Google promotes mass collaboration, making their GoogleHealth PHR service a platform for personal health records, not just the PHR itself.  In this respect, it is ahead of most PHRs in the market.  Other vendors can now add an information services registry of their HIE services, for example, and they can consume information services from other registries and information services exchanges.  SynapticHealth can help EMRs and PHRs expand their solution into the realm of mass collaboration, peaceful co-existence in HCIT & HIE eco-systems, even moving towards platform-as-a-service.

o      Transaction Processing:  Like other industries, healthcare is full of numerous transactions: clinical transactions like e-prescribing and e-lab (orders and results); financial transactions like claims and remittance processing (payables and receivables); and administrative transactions like referrals and pre-registration.  A transaction like e-prescribing (e-Rx) needs to “live” inside of applications like an electronic medical record.  How do medical record vendors scale their prescription service?  They use hosted applications that have affiliate marketing programs to help get doctors to adopt this technology.  Financial transactions like claims and remittance advices are problematic because service providers have so many payers (health plans) who have so many different transaction formats.  As payers adopt updated information services, how do providers consume these services?

o      Mash-ups: Healthcare is in dire need of mashed-up information services.  For example, the underlying transactions in the prescription world for the prescription itself, medication history, fill date and re-fill all exist – but it is very difficult with currently used technology to mash these up and call it a prescription compliance information service.  But the technology exists and is used extensively in other industries.  Transactional data is flowing with extensive clinical and financial information that is very valuable – but it is very difficult to tap into this data flow.

Healthcare Information Technology (HCIT) is in need of replicable, scalable healthcare information exchange (HIE) solutions...

 

...Specifically, the broadly defined category of “information services” that enable HIE.  Healthcare information services include:

1.   Infrastructure: application integration interfaces, scripts, transaction variants, routing protocols, HL7 (v2.x) templates, HL7 v3 XML, etc.  If you are using an integration engine that cannot exchange basic components that enable more replicable, scalable interface development, you are using the wrong solution.

2.   Transactions:  numerous transactions are now conducted via technology like web services for use in service-oriented architecture (SOA, via WSDLs, for example) including transactions like e-lab, e-prescribing, e-referrals, patient medication history, payer-provider connectivity (e.g. claims, remittance advices, eligibility verification), charity care advisement, etc.

3.   Certified HIE Processes: as electronic medical records (EMRs), personal health records (PHRs), hospital information systems (HISs), lab information systems (LISs), physician practice management systems (PPMSs), etc. become certified for interoperability with various associations and/or government agencies, a logical next step will be the development and deployment of certified information services for HIE.  Regional health information organizations (RHIOs) and other health information exchanges can now publish their services for use across scalable platforms.

4.   Solutions:  EMRs, PHRs, PPMSs, e-Rx, etc are moving towards software-as-a-service (SaaS) technology models where the entire application is hosted and distributable as a discreet information service.  HIE with a SaaS-distributed solution is theoretically easier if the solution can leverage web service-based information exchange, for example.

5.   Generic Information Services: As healthcare adopts web services / SOA or moves towards more scalable web-based applications, it’s ability to consume generic information services that are available currently in other industries will become easier and more prevalent.  These include: financial services like credit checks, payment plans and mortgage inquiries; treasury management services like payables, receivables, and deductions management; and, supply chain management and integrated e-commerce applications.

6.   “Mash-ups”:  Another reason to move towards updated HIE technology is because of the long list of information services that rely on combining multiple information services into a “mash-up.”  For example, aggregation of longitudinal patient data from multiple data sources (e.g. a patient’s valid claim data, prescriptions, lab results, and continuity of care record) would require data coordination that is currently extremely cumbersome (not at all scalable).  Master person indexing (MPI), various transactional information services, application integration, data quality management, de-identification, governance, authorization, etc are all specific information services that would constitute components of a viable healthcare information services “mash-up.”  Other example would include bio-surveillance (e.g. the aggregation of hospital diagnosis codes to determine the beginning of flu season, or a bio-terrorism incident), alerts and notifications (e.g. flagging a patient to read a web-based patient education pamphlet when a lab result, prescription, or diagnosis code is identified), etc.   EMRs, PHRs, HISs, RHIOs, etc will someday be dependent on this level of information service if we are to truly improve healthcare.

7.   Value-Added Information Services:   While many healthcare information services “mash-ups” might be considered value-added services (almost by definition), consider another definition: once we begin to truly commoditize HIE (by commoditizing HCIT infrastructure and interoperability, connectivity, transaction processing, and governance), we can then start to analyze information and improve processes or lower costs or increase ROI (for example).  Decision support tools, management dashboards, business intelligence, adjudication systems, etc now start to address profound clinical, financial and administrative processes and we begin to realize “better-faster-cheaper” results from HCIT and HIE. 

SynapticHealth is the healthcare information services exchange – a place to search for, find, publish, test, and consume the healthcare information services that will improve healthcare information exchange (HIE), thereby addressing healthcare’s most fundamental needs:

-     Commoditize HIE infrastructure like systems integration and transaction processing in order to lower financial and administrative costs (comparable to other industries) in favor of value-added clinical information services

-     Enable next-generation HIE similar to information exchange in industries like financial services by providing EMRs, PHRs, PPMSs, HISs, LISs, etc. with interoperability solutions, platforms, grids, clouds, etc.

-     Empower developers and solution providers to connect consumers, clinicians, administrators, etc. – “the any information, device, system, format to the right person, institution, etc.” – with both technology and business models (e.g. affiliate marketing of web services where publishers earn revenue share)

-     Clear the path for the value-added services that healthcare needs

-     Create technology that fosters viral expansion loops by providing develop tools and platforms where developers, companies and associations can establish their own presence in this “web of services”

 Contact us to learn more.

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