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Dimitri Popolov



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    OS31 - Interoperability; When Will We Get There? (ID 52)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track:
    • Presentations: 1
    • Coordinates: 5/29/2019, 10:30 AM - 12:00 PM, Room 201 A
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      OS31.05 - VIRTUES: Towards Interoperability in Arrhythmia Care Using Blockchain And FHIR (ID 228)

      Dimitri Popolov, Cardiac Arrhythmia Network of Canada; London/CA

      • Abstract

      Purpose/Objectives:
      As part of the network of National Centres of Excellence, CANet's objective is to improve care for Canadians with cardiac arrhythiias. One of the ways CANet is achieving this objectives is through design and implementation of VIRTUES - a cloud-based Personal Health Record focused on connecting all roles within an arrhythmia care team in a patient-centric manner.


      Methodology/Approach:
      Novel technologies/standards such as FHIR and Blockchain hold great promise for the creation of tryly patient-centric systems. CANet has piloted these technologies as the foundation for VIRTUES in order to realise their full potential and uncover limitations.


      Finding/Results:
      We have implemented cloud-based FHIR clinical data repository that has been used to enable mHealth applications in arrhythmia clinical studies. We have found that programming interfaces and overall level of technological maturity of the standard allowed us to 'steal the march' and implement working and interoperable system within the shortest time. FHIR data model is a good start, however a lot of custom data model development has to occur and these will have implications for interoperability with other systems. Blockchain when combined with FHIR-compliant data sources within the care team can tip the balance towards patients owning their records due to low costs of Blockchain ledger maintenance. However a large number of specific technical challenges still needs to be addressed around Blockchain.


      Conclusion/Implications/Recommendations:
      FHIR is undoubtedly a great step towards achieving higher levels of interoperability and has allowed us to progress faster with less development resources. Blockchain still needs to go through a 'demystification' process, however by piloting it we have accummulated a wealth of practical knowledge. We would argue that Blockchain's full potential would only be released when a high level interoperability between all systems participating in a ledger is achieved: at least syntactic interoperability, with semantic one being a distant target. Pror to this Blockchain might be used for specific business-oriented scenarios (payer-provider, billing/reimbursement, etc.) in healthcare, rather than for clinical ones per se.


      140 Character Summary:
      FHIR and Blockchain have a great potential for improving interoperability with FHIR being mature for implementation, and Blockchain requiring further piloting.