Un article de Vincent Keunen, fondateur d'Andaman7. @vincentkeunen
Andaman7 technology series #7 - No protocol API
(Série uniquement disponible en anglais)
This is the seventh article of our series dedicated to the technology of Andaman7. Our goal with this initiative is to contribute to the field of “health IT” by discussing challenges and possible solutions (more details on these challenges in our article #1). To read the previous articles, start with the first one: Andaman7 technology series #1 - Introduction.
The opinions in these series are our own. They are based on our 25 years of experience in the field building large scale EHRs (Electric Health Record) and medical information exchange systems (1). We share them in good faith to help move the needle forward and inspire others. And of course, we also want to promote our own Andaman7 initiative, a project by patients for patients (2). Terms and acronyms are explained in our lexicon (3). We are open to and welcome discussion on these topics. You can find us on LinkedIn, Twitter and Facebook and we can also discuss on other media you would like to invite us to.
Today, let’s talk about No protocol API.
For more than 30 years, health IT has come up with new and better standards. The result is a long list of “not so standard” standards. Data exchange standards include: e-mail, ftp, direct, APIs, web services and more. Data formats and codification systems abound, making things even more complex. Every new standard (eg. FHIR) brings the hope of the holy grail: interoperability.
We recognise the need for and benefits of standards. But to be successful, standards must be (at least) free to use, well documented, easy to implement and popular. Many standards, sadly, don’t fit the previous description, FHIR is becoming the exception as adoption and documentation are growing steadily. However, it’s not that simple. And today, it is still focused on care stakeholders while other formats are targeted to the research sector.
At Andaman7, we did not want to wait for the “solution that is on the horizon and that will solve all problems - eventually”. We did not want to use a proprietary format either, like many vendors do.
So we came up with an open, “no protocol” API that simply goes to the roots of information processing (using foundational programming data types) with a thin “business layer” taking into account the specifics of the health sector (based on a limited set of “Atomic Medical Items”, or AMIs). You may want to read more about our data model in “Andaman7 technology series #4 - Liquid data model” and “Andaman7 technology series #5 - A common foundation for care and research”.
The “no protocol” term was created in the same spirit as the “NoSQL” term and means that no knowledge of HL7, FHIR or any other protocols / formats / codification systems are necessary. This “No protocol API” is closely tied to our simplified data model. It’s simple to use, is a bit more elaborate than simple “computer language data structures and protocols”, but not as deeply rooted in the business domain as many others (with advanced, therefore complex, data model schemas). Since we wanted to use our Andaman7 data structures and protocol in two domains (care and research), having a “cognitively poorer” schema and protocol was a good idea.
This “no protocol API” has allowed us and partners to set up interoperability with other systems in record time (a few days to a few weeks of work), including bidirectional information exchange. It has also allowed us to bridge the gap between care systems (EHRs) and research systems (EDCs).
Let’s be clear: we do recognize the importance of de jure or de facto standards (like HL7, FHIR, ICD, LOINC, Snomed, DICOM, CDISC, ODM…) and continuously build bridges to those standards to extend the ease of integration of Andaman7 with systems supporting them. We plan to support all sufficiently popular standards.
The “A7 protocol” is to mobility and modern Internet what HL7 is to classic and sometimes complex health IT systems.
That’s it for today. Our next article will be on “Extreme traceability”.
To read the summary of these articles, combined into our white papers, go to:
- Andaman7 Technical Innovations: http://bit.ly/a7TechInno
- Andaman7 advanced health data management: http://bit.ly/a7DataMan
(1) In a previous company, we built a prevention-focused EHR that is today used for some 1 million people (most are in good health, some are patients). We also built the technology for the two largest “medical messaging systems” of Belgium, still being used today by 90% of all hospitals and doctors.
(2) Read our story.
(3) Consult the lexicon. It's a work in progress. Don’t hesitate to make suggestions and remarks to firstname.lastname@example.org.