Secure Interoperability Solutions for Public, Private Healthcare

Q: What are the key components of interoperability in a digital health ecosystem and how does Health Gorilla’s services offer the best solutions for this ecosystem?

A: Health Gorilla was founded in 2014 to build an API based on Fast Healthcare Interoperability Resources (FHIR) that addressed the realities of the laboratory industry, allowing it to receive results electronically in one single platform. The goal was to present a solution that could stand alone or be embedded. This solution would allow any doctor to request different tests from any laboratory, receive the results in a single platform and share those results with whomever has the right to access it, which depends on location. We follow the legislation of each of the countries we work with.

The innovative idea is not the connections because anyone can connect to anything. The difficulty is that different laboratories and doctors use different systems and structures. Health Gorilla is able to digest the information produced by all these different companies, normalize it, match the patient with their master-patient-index, duplicate it and generate a single health record for each patient. The patient does not need to go to each individual laboratory to get results.

Q: How is Health Gorilla entering the Mexican market? What opportunities do you see in the public or private sector?

A: Our company is based out of California and our first Latin America customer was Puerto Rico, where the regulatory space is US-based but the culture is similar to Latin America’s. A Mexican private hospital network encompassing over 30 hospitals, 24,000 providers and 30 million patients was intrigued by our work in Puerto Rico. Our work with the Mexican hospitals connected all its areas, including radiology, hospital system and laboratory system. Now, the network has a single profile of the patient no matter which hospital the patient uses and that profile can be provided through an app to the doctors who need it.

Q: What have been the challenges Health Gorilla has found in offering patient services through different mobile devices and different hospital infrastructures?

A: The issue is not the technology but the processes and resources. We connect to over 100 standard formats and we need to obtain the governance, data-usage agreements and the trust from each participant. Technology is not a big barrier as long as we are dealing with standards. Health Level Seven (HL7), an international standard for the transfer of clinical data, is a great example. While it is a standard, not every hospital or laboratory has the same internal resources and processes, so we need to determine where the data is and how to exchange it. Then the problem is the content and its quality. Many systems are different. For example, some recognize accents while others do not.

In Puerto Rico, we created a master patient index in the system used by one of our customers is the Department of Health and they are using Health Gorilla’s master patient index and will share with the entire ecosystem, giving patients a unique identifier to reduce errors or duplication.

Q: How do you handle the lack of information in patient health records? How is this information translated as the patient navigates different environments?

A: One of the reasons for our success is that we do not replace anything; we just add to it. Some of our customers then decide if they want to replace something, but that is their decision. Systems that do not use FHIR as their standard can do so gradually. Many clients do not want to deal with the cultural rejection of the new system, which is happening in Mexico. Some hospital systems are buying others but they should not rip out and replace the existing system because it takes time for users to learn the new one. Technology rejection can make a project fail. Having us in the middle frees that company from the need to replace a system. It can gradually substitute processes.

In Puerto Rico, we connected over 50 hospitals with different channels and systems in less than a year. In the case of COVID-19, the system provided additional information for the optimal use of the public and private sectors’ limited resources by compiling all necessary information on a centralized data base with data from over 1,000 laboratories. Having centralized information allows for faster campaigns and responses. During a natural disaster that displaces thousands, for example, having centralized information allows the government to forward medical information to hospitals and provide better service to those who have been displaced.

We are also working with insurance companies to manage the clinical information of consenting patients to better manage risk and provide better rates.

Q: What is Health Gorilla’s approach to cybersecurity and what role do you think this should play in the digitization of the sector?

A: Cybersecurity is the most important aspect of this business. Health information is more valuable to cyberattackers than credit information. We use different technologies to protect patient data and follow the best security procedures. Our processes comply with the US Health Insurance Portability and Accountability Act (HIPAA). We use Amazon Web Services, our platform partner, in Latin America and Mexico. Our technology allows us comply with local laws and keep the medical information of Mexicans in the country.

Q: How ready is Mexico’s health system to integrate tech at all levels and to make it interoperable?

A: Latin America’s countries are at different technological and regulatory levels. But the incorporation of technology will create a domino effect in the region. Chile, Mexico and Peru are welcoming technology. Chile has invested strongly in the FHIR system. The country has programmers and a deep understanding of the importance of the standard. What it is missing is trust. Companies need patient consent to use the data. The system must follow all business rules regarding access, consent and regulation because without them, there is no trust.

In Mexico, there is interest but there is also little trust in exchanging information. In the US, the government is forcing people to exchange data. The 21st Century Cures Act in the US is forcing insurance companies to create a payer-to-payer data exchange in which providers have to exchange data if the patient changes their healthcare system. But this process is being delayed.

As we move forward, it is important for everyone who participates to see and understand the value of data, especially the patient.

Health Gorilla provides secure interoperability solutions that enable healthcare organizations to seamlessly access the data they need to deliver high-quality care.