White House Responses and some thoughts on "Web 3.0"
- jschremp
- May 7, 2022
- 2 min read
Was fortunate enough to receive word that the top line read out on the "Community Connected Health" RFI had been compiled and published:
We are clearly heading into strong head winds in the digital health funding space. But, I am heartened by the evolving understanding of what is necessary to overlay these types of technologies into population health.
On a somewhat related topic, I recently saw that twitter thread asking what the biggest problems for API data exchanges in healthcare were/are. While many comments were focused on the often labyrinthian pathways to connect with even sophisticated EHR platforms; I went in a slightly different direction. Namely, the underlying data mapping and semantic decision making within network specific databases.
Without going hyper deep into that here, there are differences in the way that even "simple" mapping of discrete concepts is done at the installation level for large network EHRs. So, for a rough example, think about a patient's medication list. The list is a log of of the orderables released to the patient by the system and by manual input by end users of that system (or in bulk update from importing external records). These are often formulary depend precise orders that may have mild semantic or generic drift from how another organization may list the same medication. Add in the additional layer of risk of not building out an accurate or up to date NDC code tied to the distinct orderable and you rapidly move into a match nightmare across datasets.
What does that mean? Well, for my money, even a world of pure API open standards and perfect FHIR pull capabilities will not solve for the underlying issue of lack of trust and contextualization of pertinent health information. *And, I should add* that's even just including the promise of large org (network to network, network to payer) type exchanges. The problem is made worse via the introduction of wearables and patient reported outcomes (PROs) being tossed into the pool.
All of this is to say, I'm talking myself into the reality that Web 3.0 (I know) may be a part of the underlying architecture that allows the intended goals of the triple (or quadruple aim) imagined in rapid/real time health care data exchange and high fidelity use to be achieved. I'm just not completely sure what that looks like yet. (For bonus points the thumbnail imagine for this posting is from my taxes this year where I had to input my crypto holdings. Specifically here I am listening the cost basis for algorand that was gifted to me by Coinbase :) about as close as I currently am to web 3).
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