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Modern Data + AI Integration:Strategies and Architectures

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Implementing Advanced Healthcare IT with Nexla, FHIR, and SMART on FHIR

Exchanging data in healthcare systems has historically required the generation, transmission, and processing of unique documents for every set of data. Not only is this process time-consuming, but the transmitted data sets also often fail to provide needed additional patient context; additionally, a single patient’s data can remain distributed across multiple facilities without connection. The Centers for Medicare and Medicaid Services has mandated that every healthcare organization, life sciences company, medical laboratory, and other entity that maintains U.S. human healthcare data must expose that data via the FHIR data standard. As a result, healthcare data access and exchange are becoming simplified, and obtaining coherent records of patient data collected across disparate healthcare organizations requires far less effort.

The standardized architecture and practices defined by the FHIR protocol enable healthcare providers to more easily obtain coherent patient data, but with the right data solution, the FHIR protocol can also allow the healthcare industry to achieve much more.

Faster Technology Adoption In Clinical Practice

Healthcare technology advancements are facilitating broad leaps forward in patient care, but implementation is often hampered by data handling procedures. For example, one U.S. healthcare system observed a 54% decrease in asthma-related emergency room visits and a 57% decrease in associated hospitalizations following the implementation of a system consisting of inhaler sensors and a digital therapeutics platform. The inhaler sensors, which monitor inhaled medication use, sync with patient smartphones via a Bluetooth connection and transmit their collected data to the digital platform, which then provides alerts and insights to both patients and caregivers.

However, even with the promising results achieved by this system so far, its adoption by clinics continues to be slow due to the added administrative burden associated with identifying and enrolling patients and monitoring their data. The digital platform has been integrated with one electronic health record (EHR) system in an attempt to decrease this added labor requirement, but each EHR integration requires lengthy development, testing, and approval processes, which continue to present implementation barriers. In contrast, with Nexla, clinics can much more easily implement this and countless other healthcare IT systems based on the FHIR and SMART on FHIR protocols.

Nexla’s low-/no-code bi-directional connectors can rapidly interface with medical devices—such as medication monitoring devices, pressure sensors, and other biometric sensors—to import collected data at any volume and velocity, including real time. Healthcare providers can use Nexla to automatically flag missed medication doses, vital signs exceeding specified limits, and many other events based on imported sensor data, as well as to perform data transformations and/or combinations. Nexla can also deliver the collected data to any FHIR server-based system—e.g., a digital therapeutics platform or EHR system—avoiding additional workloads required for conversion, transmission, and transfer interface engineering. Thus, Nexla opens the door for clinical adoption of cutting-edge healthcare IT and IoT devices with any FHIR server-based EHR system without compatibility, integration or workload concerns.

Wearable Devices for Patient Recovery

In the past, monitoring patients recovering from procedures was limited to observation in hospitalization settings and subsequent follow-up visits to healthcare providers. While effective, this approach can lead to longer hospitalization periods and delayed or even missed identification of complications. Advancements in wearable health-monitoring technology, from smart watches to specific medical sensors, could contribute to improving the patient recovery process; however, the problem lies in accessing, transferring, and analyzing the data that these devices collect.

With the consistent architecture and standardized semantics of FHIR servers, along with a data solution like Nexla, wearable health technology can now play a significant role in patient recovery and monitoring. Devices can be issued to patients during the recovery period to monitor relevant biometrics such as blood pressure, heart rate, oxygenation, physical activity, stress, etc. In some cases, patients may even be able to grant permission to allow their already-owned devices to provide the needed metrics. Nexla’s streaming connectors can interface with each device to transfer collected data to any platform for monitoring and analysis without increased administrative workloads. This data can be transferred in real time, allowing care providers to track recovery progress and providing alerts when critical metrics deviate outside of predefined thresholds. Nexla can also obtain data from any EHR, achieving real-time and batch data fusion to produce a complete picture of relevant data specific to each patient. By providing these capabilities without requiring increased workloads or the delays and costs associated with custom interface construction, Nexla lets healthcare providers more easily implement advanced technology for improved post-procedure care.


Clinical Trial Data Collection

Healthcare studies conducted to test and approve new treatments or devices require the accumulation and analysis of large amounts of data. This data may come from any combination of in-person patient surveys, exams and follow-ups; health records; medical devices or sensors; etc. Obtaining the required types and volumes of data as well as transferring collected data to analytics platforms present major challenges in clinical trials, but using Nexla with data from FHIR servers and SMART on FHIR apps can significantly lower this hurdle.

Currently, most clinical trials require collected patient data to be manually entered into various electronic data capture (EDC) systems used for analysis. As of mid-2021, a typical phase III clinical trial generated 3.6 million data points, and this total is expected to continue to increase. Consistent exposure of patient data through FHIR servers takes a step toward solving this workload issue, but needed data must still be transferred from sensors, EHRs, and other sources into EDC systems and additional analytics platforms, often still requiring manual data entry or the creation of custom transfer protocols for each system involved.

Nexla can connect to any data source to seamlessly aggregate and transfer patient data to any destination. With the current time to market for new pharmaceuticals standing at 10-12 years, getting trial data into the appropriate system quickly and without creating multiple transfer protocols presents a significant opportunity for time savings. Additionally, researchers can create custom data products called Nexsets with a few clicks to facilitate rapid subset analyses. A Nexset can contain a cohort of participants who experience a specific adverse event, those who are also taking a particular medication, and countless other variables that are important aspects to be considered in clinical development. Both auto-generated and user-generated Nexsets can then be delivered to any analytics or monitoring platform.



Nexla Makes Working with FHIR Data Simple

From easing the transition to FHIR server data exposure to the above applications and more, Nexla can help healthcare organizations make the most of the increased accessibility of healthcare data based on the FHIR protocol.

For a step-by-step introduction to working with FHIR healthcare data in Nexla, check out this blog post, and request a free demo and trial for a more detailed explanation of how Nexla can help your organization.

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