Written by Lucie Keunen
Product Owner Andaman7
Android 3.0 - iOS 3.0
Interoperability is the ability of different hardware, software, or protocols to work together and share information. This capability is crucial to enable Andaman7 to interface with a growing number of data sources. To achieve this goal, the Andaman7 IT team has developed powerful mechanisms to make its platform and app compatible with many other systems.
Why is it important?
One of Andaman7's main missions is to give everyone the opportunity to create and keep up-to-date their own health record. The more complete the case, the better the benefits in terms of quality and efficiency of health care.
One of the biggest problems currently in the health field is the lack of quality communication between the different actors. Most often, we can observe that the data is isolated in silos and the information sharing between the different health professionals and / or with the patient presents strong gaps. In some cases, this can be detrimental to the patient, for example when a care path is developed without an overall view of his/her situation. It can also lead to unnecessary costs when the patient has to repeat medical examinations simply because the results have not been shared.
It is therefore essential to improve communication between the various stakeholders, for the benefit of all. But that is not easy! In IT, as in real life, to understand each other, you have to speak the same language! And that's a reality: not all hospitals, labs, pharmacies, and the like use the same software and data formats to manage information.
To enable patients to retrieve their health data from more and more sources, and thus facilitate the enrichment of their health record, Andaman7 attaches great importance to interoperability, and our product team devotes a good part of their work to make it possible to integrate Andaman7 with other systems.
How does it work?
For two computer systems to communicate together, they must speak the same language. When this is not the case, it is necessary to set up "translation" systems between the two systems.
At Andaman7, the data format is unique, allowing its extension in a highly flexible way (for more information on this topic, please read the paragraph "Liquid data model" in the Andaman7 Technical Innovations white paper). Although this format brings many benefits, it is still different from what is “out there”. We had to develop "translation" tools to import data in Andaman7 from other sources in a different format.
The first data format we chose to become compatible with is FHIR (Fast Healthcare Interoperability Resources). Why? Because it is a standard for the exchange of health data increasingly popular in the United States and all around the world. FHIR uses two other standards for data exchange: LOINC (1) and SNOMED (2). Both standards use codes to identify health measures and observations (LOINC) and their values (SNOMED). For example, the terms "heart attack", "myocardial infarction" and its translations into other languages, which represent the same thing but with different words, will be covered by one single code. By using these codes, the data is structured, making their exchange and processing much easier and more reliable.
One of the main challenges for Andaman7 was to be able to use these standards on mobile devices. To give you an idea, LOINC has about 80,000 codes while SNOMED covers about 350,000 concepts. It is unthinkable to store that much information on a smartphone or tablet. Andaman7's IT team managed to get around this difficulty with great ingenuity. They have put in place a dynamic system allowing mobile devices to retrieve codes and their translations on demand, according to the specific needs of each patient. A real technological nugget!
Where can we see it?
Developments to increase Andaman7's interoperability capabilities are not "directly visible" to users as such, but they are linked to a bunch of new services and make their operation possible. For example, in the "Services" tab of the mobile app, you will see that Andaman7 now has the ability to import data from 300 hospitals in the United States! All this is only possible thanks to our compatibility with FHIR, LOINC and SNOMED!
(1) What is LOINC? (source: https://loinc.org/get-started/what-loinc-is/)
"LOINC is a common language (set of identifiers, names, and codes) for identifying health measurements, observations, and documents. If you think of an observation as a "question" and the observation result value as an "answer." LOINC codes represent the “question” for a test or measurement. Where needed, codes from other standards (e.g. SNOMED CT) represent the “answer.” Of course, you don't always need a code for the result value. For quantitative results, the "answer" is just the numeric value—with its associated units of measure."
(2) What is SNOMED? (source: http://www.snomed.org/snomed-ct/five-step-briefing)
"SNOMED International sets international standards for health terms. SNOMED CT:
- Is the most comprehensive, multilingual clinical healthcare terminology in the world,
- Is a resource with comprehensive, scientifically validated clinical content,
- Enables consistent representation of clinical content in electronic health records,
- Is mapped to other international standards,
- Is in use in more than eighty countries.
The SNOMED CT clinical terminology has unmatched depth, enabling clinicians to record data with enhanced accuracy and consistency. SNOMED CT remains a growing and evolving product made better by the Community of Practice.”