Healthcare services are going digital, from recording clinical care to providing services using information and communication technologies (ICT). Clinical care is complex and ICT enables clinicians to do more than simply record what they are doing, or find information electronically to support their work. There are opportunities to change the way we organize and manage healthcare delivery to positively impact the outcomes achieved, e.g. increase safety.
Some patients experience adverse events related to clinical interventions, e.g. serious allergic reaction to medication. Under the National Adverse Events Reporting Policy of 2017, health services are obliged to report serious adverse events according to a specified protocol, within 15 days of the event occurring. Most adverse events are originally documented in medical records, managed either by general practitioners (GPs) or hospitals.
Since most medical records are digital, it should be possible to collate data digitally into a structured reporting format for submission. However, the record is not a single software application (programme) – it consists of several applications that function according to specific aspects of clinical care, e.g. medications are managed in an application that attaches to the basic information about patients.
Efficient reporting is hampered by the lack of standard data formats, because each medical record system has its own proprietary approach to data storage. As a result, some data can be shared but most of the data cannot, i.e. data has to be collected from each separate application. It becomes a challenge to report adverse events that require data from several applications that are not interoperable (unable to share data).
HL7 New Zealand, the local affiliate of an international standards setting organisation that specialises in standards for data interoperability, is hosting a ‘Developers on FIHR’ Challenge in collaboration with The University of Auckland. FHIR (Fast Healthcare Interoperability Resources) is a draft standard that makes use of data formats and elements structured as ‘resources’ which are shareable though Application Programming Interfaces (API).
For the ‘Developers on FHIR’ event we invited those who are actively involved in software development, user interface development, system architectures and clinical care delivery to form teams and build applications to solve interoperability challenges associated with reporting adverse events.
The research question is ‘How does a formally organised developer challenge facilitates the development of clinically impactful, interoperable health information technologies?’
People were required to register for this free event, attend webinars to learn about FIHR (interoperability software), form teams, and work on a solution using FHIR. We held a one-day in-person event on 17 March 2018 in which people completed a minimum viable product for their interoperability solution, presented it to the Challenge Judges, and found out who won the Challenge.
The research consists of (1) a literature review about interoperability, adverse event reporting, FHIR use, and hackathon processes (the Challenge followed a typical hackathon process), (2) interviews with registered Challenge participants about their experience, and the judges (3) a reflective interview-discussion between the two HL7 hosts and the researcher, and (4) a post-event evaluation survey about the strengths and weaknesses of the hackathon process and structure. We will do thematic analysis of the interviews and a combination of content analysis and descriptive statistical analysis of the evaluation survey responses. We aim to publish our findings in a journal article.
To find out more about the research, download this Participant information sheet Challengers, or this one for Judges.
Once you decide to participate in the research, please complete this Consent Form Challengers and this one for Judges and return it to Karen Day at k.day@auckland.ac.nz.
Approved by the University Of Auckland Human Participants Ethics Committee on 14 March for three years, reference number 020754.
Day by Day 