Interoperability, HL7 FHIR Testing Sandbox Offers Place to Explore

“Fail. Fail often, fail fast, and learn.” That’s the philosophy for Mary Kratz, the executive vice president of the Interoperability Institute (IOI), as she and her organization wraps up a simulation session to test widespread interoperability through HL7 FHIR implementation.

At the 2021 Center for Medicare and Medicaid Services (CMS) HL7 FHIR Connectathon, healthcare stakeholders convened to test HL7 FHIR Implementation Guides and Reference Implementations to understand how they can tackle current health interoperability challenges.

At the CConnectathon, stakeholders leveraged IOI’s open-source sandbox offering, MELD, to test HL7 FHIR resources for various use cases, including social determinants of health data exchange, patient access application programming interfaces (APIs), and payer to payer data exchange. 

Kratz told EHRIntelligence in an interview that IOI preloaded the cloud-based sandbox offering with what the HL7 community refers to as “test data.”

These data sets are created through machine learning and AI-methods to emulate real world data so stakeholders can simulate the various use cases.

Kratz noted that IOI’s offering went off without a hitch, allowing stakeholders to assess their health IT’s interoperability potential in a simulated environment.

“We were excited that the MELD Sandbox worked seamlessly,” she said. “The users that were on it and utilizing it for the CConnectathon activities didn't have any major issues. It was also really nice to see that our synthetic test data complimented the activities that were underway with the community to advance and further interoperability. We were just delighted to be able to contribute those resources.”

Which harkens back that philosophy of freedom for failure. Kratz said that because the Connectathon utilized synthetic data, participants were able to deeply explore with little consequenc, leading to what she said would be more fruitful innovation.

Connectathon“Often, we're afraid of failure, but the Connectathon environments give us a safe place to bring all of the resources from different actors in the community together and to be able to fail and learn together with that highly realistic synthetic data,” she continued. “We really see that as our mantra for building a community that can go far and enable healthcare interoperability through the power of partnerships.”

Kratz explained that data, knowledge, and process need to come together to enable interoperability.

“A lot of other industries that are tied to healthcare have done process modeling for years, like the finance and manufacturing sectors,” Kratz noted. “The healthcare industry is a little bit lagging when it comes to putting together well-defined processes.”

Collaborative events that allow stakeholders to test their health IT help bring these key tenants together, she explained. By utilizing synthetic data, developers can test their processes to ensure that their health IT promotes interoperability by providing knowledge to the provider, patient, and payer.

MELD evolved from IOI’s private sandbox product, Interoperability Land. Kratz noted that many customers wanted to try the offering but didn’t want to pay for the health IT up front before “kicking the tires.”

This spurred IOI to create the open source, publicly available sandbox offering which gives stakeholders a place to come together to learn about interoperability at scale.

Additionally, Kratz explained that IOI is working to promote innovation among the next generation of health IT stakeholders through its workforce program, which currently has over a hundred student interns seated.

“We are working with academic partners to grow and expand the workforce program to provide early career opportunities to train up the next generation health IT workforce, and to compliment academic degree granting program through paid internship,” Kratz explained. “As part of that, we're also working with those university partners to develop course packs that run on the sandbox environment.”

Kratz noted IOI’s workforce program has contributed to interoperability efforts through the creation of resource kits.

“One of the lessons that came from our workforce program is that the FHIR resource definition is pretty broad,” Kratz explained. “It really isn't standardized within the implementation guides.”

Through the workforce program, an IOI intern developed a HL7 FHIR resource kit that provides the first level of standardization between the semantic and the syntactic layers of interoperability, Kratz explained.  

“That was really exciting and came out of being able to participate in these Connectathons,” she continued.  

In addition to academic partnerships, IOI works with both public and private stakeholders to bring together thought leaders across the health IT industry, Kratz said.

“Working with stakeholders that compliment our own health IT development teams helps to move some of these open source assets forward for the industry to be able to use and reuse to further interoperability,” Kratz said. “I always go back to the mantra of Nelson Mandela, ‘If you want to go fast, go alone. If you want to go far, go together.’”