This year, attending ViVE 2022 in Miami Beach meant seeing new faces and reconnecting with old friends. Michelle Blackmer sat down with Sandy Vance to discuss data interoperability and the future of healthcare IT, as well as how large organizations are handling post-pandemic consumer expectations.
Listen to the audio here or read their entire conversation below.
SV: I’m Sandy Vance and I’m here today with Michelle Blackmer, the Chief Marketing Officer of Rhapsody. Please introduce yourself to our listeners. I know you’ve spent a lot of time in the healthcare industry, and I think it would be good to just kind of understand your history.
MB: Yes, I started my career in implementing radiology information systems back before electronic medical records existed and then moved to implementing electronic medical records —the first one Centricity — and I experienced, as GE made the acquisitions to build out the Centricity portfolio, that our customers really couldn’t share that data even within our own applications. And that’s how I became really passionate about interoperability. And then from there that led me down a path of master person index, which I find patient matching to be a critical element to truly having an interoperable healthcare system. And so about two years ago, I was approached by Rhapsody. Rhapsody was formed through the acquisition of Rhapsody and Corepoint: two integration engines or interoperability platforms. It was at the start of the pandemic, I was seeing this opportunity for interoperability that’s never been bigger, and so it was a terrific time to join the team and to shift from thinking about patient matching to really connecting the entire ecosystem. And so it’s been a long time. Somebody brought up CCHIT yesterday, and I’m like, whoa, that’s a throwback. It definitely has been a long time, but it’s exciting to see everything here this week and how far or interoperability really is coming.
I started my career with Centricity products as well. So yeah, I totally get the lack of integration that was with that. And when you think about just acquiring the data and how far interoperability has come since that time, now it’s all about data up-cycling and keeping it clean and the insights that come from that.
Right? Now it’s not just “let’s get the data”. It’s, “how do we normalize the data? How do we understand who has the data? Where does all the data reside? Tell me the data about the data. Now we care about metadata, right?”
Totally. So how do these two flagship products that you have help organizations with that?
So public health agencies, healthcare providers of all sizes, and healthcare technology companies rely on Rhapsody solutions to connect data. We talk about building connections. They’re using the products to share HL7, I would say first. But also web services, managed file transfer, APIs, any type of data that needs to move about a patient they’re really relying on Corepoint or Rhapsody, and even our new integration as a managed service, which is Envoy, to help make that happen.
So if I’m a running a hospital, I’m like, why do I need that? I have one of the big one, I have an EMR, I have a portal. Like, why would I need this?
Well, first, even when you have your EMR: you’re trying to share that data with your data warehouse or other trading partners across your enterprise, or maybe you’ve adopted a CRM and you need to share or make patient data available in the CRM. Or personal health records are demanding access to this data. I think I heard there’s 500 digital health startups here this week, is that right? A bunch. And so all of these startups are creating new opportunities and they need access to data, which is creating a pressure on payers and providers to make that data available and Rhapsody is right in the middle to be able to facilitate that movement of data.
What trends are you seeing with this data enrichment process, are you guys tackling that at all ? Because obviously you’ve gone through this spectrum as we’ve grown to where we’re at.
We are. So one trend that we’re seeing is M&A. I really believe that will continue to accelerate as we’re on the— hopefully, knock on wood— tail end of the pandemic here as organizations are considering making a purchase they need to know what patients we have in common. And then as they onboard organizations, they want to rapidly connect all of the data together and ensure, you know — are we creating data quality issues? Is there data that we can augment in the data that we have from an organization that we acquired? So M&A is creating a data management challenge for health systems. I see Rhapsody playing a big role in helping them be more swift in integrating those organizations. Also, healthcare technology companies themselves who are trying to connect all of the providers and payers together, helping the consumers be more connected to providers, they’re focused on their core competency, and we want them focused there. We want them to be thinking about innovation, not to be rebuilding integration and interoperability that already exists. And so that’s where we’re seeing them turn to Rhapsody and say yeah, we need a proven, trusted solution that can manage HL7, JSON, FHIR. Just make sure the data gets there so we can put our developers on innovation.
Yeah that’s a really good point and one I hadn’t quite thought of. So beyond acquiring the data, which we’re like, yeah, okay, you can solve that for them, but there are all these apps now popping up and platforms that are meeting specific needs: mental health, consumer, sort of coordination of care type apps. Are you behind some of those?
Yeah, absolutely. So two of our customers OnCall and Orbita are in this telehealth space. We work with technologies like Clinify, another solution that relies on Rhapsody to help them gain access to the data that they need, and then make that data available back to the electronic medical records. So all of this is about making care providers more efficient and easing the burden, right? This is a tough time for health system care providers. I don’t think there’s ever been a harder time for them. They’re not feeling happy and the more that we can simplify how they take care of patients the better. And so all these applications intend to do that. And the more we can help surface the data in them and then back for sure. And then organizations like Phillips rely on Rhapsody to bring data between their devices. So that’s a really big part of our opportunity.
You’re doing device data integration as well?
Well, they’ll they need patient data in the devices. And so they’ll use Rhapsody— they’ve embedded Rhapsody Integration Engine inside their solution.
How do you think the Cures Act is going to impact what providers need to do with their data?
We had a provider stop by the booth this week, and she was saying that her organization, they use Corepoint Integration Engine, but they have not really defined an interoperability strategy. And she was in sessions about the Cures Act this week. It was hitting home for her— “Oh, wow. We need to be getting ahead. We need to think about this and define an interoperability strategy.” I don’t think she’s alone. I think the pandemic caused a bit of a delay in making it top of mind maybe for providers. And some provider just haven’t— they’ve thought about it very reactively. What data do we need to move, but not so much, let’s have a proactive interoperability strategy. I think CIOs are definitely starting to outline “what should my strategy be?”. We had a lot of requests this week for, “can you help me put together a strategy”, and they’ve thought maybe about an interface engine and some data integration, but true interoperability as they’re having to connect with payers, all these digital health applications that we were just talking about, sharing data with patients, for the Cures Act. It is increasingly top of mind and I think it will help them drive a true interoperability strategy.
Definitely. I think that having to, to your point move across those different stakeholders; so we’ve done payer to payer pretty well, we’ve done provider to provider pretty well, and now we’ve got to move the data back and forth in between those. And so that’s something that, yeah, they need a strategy.
And a pragmatic one, right? Like nothing will be retired, HL7 won’t go away. I don’t believe FHIR in the short term or long term really replaces HL7. And I wouldn’t want it to because HL7 works. We know we need something more than HL7. So FHIR fills that, and there will be other or standards as well that will help fill additional gaps. And so I think that CIOs, CDOs at healthcare organizations are approaching this in a pragmatic way to say, “how can we have an additive strategy that continues to evolve as interoperability evolves?”. And that’s what we’re doing as a company too, is building solutions to meet the market where they are. And not saying, hey throw the baby out with the bath water, get rid of HL7 go to FHIR, but certainly adopt FHIR and pair it with what you have in HL7.
Sure. So, do you do the sort of roadmap services for that and help them lay that strategy out, providers?
We’ll help them outline a strategy, for sure. And engage partners where we need to as well.
Talk about that.
We have a whole, we call it an ecosystem of partners, both technology and services partners. So when we think about interoperability, we’re very focused on data management and that includes data quality. But we recognize the necessity, for example, to have a FHIR server or to think about terminology. And so we have partners that we have agreements with to bring them into solutions. And then our solution architects are thinking across that whole portfolio and collaborating with our partners so that when we talk with healthcare providers and public health or agencies, we can help make sense of this landscape. Because you know, I think if you walk the show floor, the messaging looks very similar from one booth to another. And it can be confusing for the buyer here to look and try to distinguish, “wait, how are you different from, you know, everyone’s talking about interoperability, everyone’s talking about FHIR, how are you different?”. And so we’ve curated this portfolio of, uh — we’ve gone two years and we haven’t been able to kick each other during the podcast, and now we can.
I just kicked her under the table. I’m like, oh, sorry. We don’t interact in person anymore, do we?
I know we’ve gotten so awkward. Right? But we’ve curated this portfolio of partners so that we can help take the confusion away for providers.
That’s awesome. It is really hard to tell what these systems are doing. I had a couple of questions about that in the InterOp booth. Like they all say they’re data integrators and platform solutions and they all do very different things. This one is a consumer app. This one is like total infrastructure behind the scenes sort of stuff. So that is tough.
You’re having to, as a provider peel back of layers and understand. And I then the EHR vendors also saying, “oh we have integration, we can do it well enough”. And a lot of times you go down the path and then you realize, oh we should have had this solution, that’s expensive. And that hurts your strategic initiatives. And so because we did acquire Corepoint and Rhapsody, we have over 40 years of experience in integration, in interoperability. And so we’ve seen how the market’s evolved and we really try to bring both that experience and a forward looking perspective to the table to help our customers.
Yeah. It’s so important to be able to identify what those systems do. But also I think an organization like Rhapsody is really unique because you are working together with so many of those other things. If you had one sort of crazy prediction for the future that like nobody saw coming, what do you think in the next five years this is going to look like? We’ve got all these apps popping up. We’ve got all of these different FHIR solutions. We know CCDA is not going away. We know there’s still going to be other standards that have to be used. We’re going to have to learn to work. I mean, we’re still doing cloud facts for crying out loud, like stuff that works doesn’t go away, period. Like we just keep using it and building on it. So, you know, what does that look like?
I don’t know how crazy this is, because it feels very pragmatic, but with the acceleration of a desire for no code, low code and the pressure that organizations both from a digital health perspective and a healthcare delivery per perspective are under to share data that, that crunch that exists in the middle. I believe that data on demand is where we’re moving. So people don’t have to take all of the data in. Like send me all of the ADT about every patient. And then I parse it out and I take what I need and I send in where it needs to go. Or I use it for the workflow where it’s needed, but I could request like I need to know this information about patients that are coming to me on demand. I see that, at five years is probably ambitious, but I think that’s the direction that we’re going. One of our customers talks about interoperability at the edges and they’re really saying, I can’t count on a centralized IT team. I can’t scale them to deliver all of the integration and interoperability that I need. I need a simpler way for them to feed in the interoperability that they need. So I think managed services are one way to close that gap, but also technology that just makes it easier for people to subscribe to the data that they need as a reasonable place to go.
And that’s what the FHIR API ecosystem is supposed to do for us, Right? And I think that consumers are demanding this too. We manage every other aspect of our life with our data on demand, why can’t we do that with healthcare? Right? And so I think that it just becomes all that more important with trying to meet the consumer demand.
Yeah, I agree. And the pandemic brought consumers to expect care, look at telehealth, right? We’re never gonna give it back. We’re not gonna say, oh yeah, I wanna drive to the doctor. I need to leave my office for three hours to go to a doctor’s appointment when telehealth is an option. We’re not going to go back. And so I love that we have consumer demand now because that’s how change really happens, is when the market demands it.
Yeah, yeah, absolutely. That sort of unexpected innovation, I think. And it’s good that it’s pushed it forward. So how do you think telehealth has driven that on demand information, right? Do you see that maybe providers have had to step up and be more and do more and give the consumer more because they’re doing so much telehealth?
I think so. I think of myself just getting a test to come to this conference. I went to online to request an appointment. I was frustrated that they didn’t have the 15 minute slot that I wanted available. Like this is my expectation. It used to be I schedule with my doctor: Oh, I come when you’re available, right? But now I logged in and oh, they don’t have the time I want, I went to another clinic option to find the time that I wanted. And then I book that, I go for the test, I drive up, get the test. They come out, they take care of me when I get there. I’m not waiting at all. And then, they deliver to my email, the results. My expectations are higher. I can’t be alone. I think that certainly there’s no way to walk back on that. I don’t agreed.
Yeah. Agreed. A hundred percent.
How are you hearing people talking about FHIR this week? What momentum are you seeing?
Yeah, we had some great sessions actually in the InterOp pavilion around some of the FHIR accelerators. So the payers have obviously rallied together and have built these implementation guides that have become part of the CMS interoperability rules. And so it’s exciting to have the implementation guides and like, we’ve built the spec and we’ve built the implementation guides that people can follow them. And now I think it’s about real world adoption and making sure that that organizations like Rhapsody and like all the bajillion edge systems that you interact with are paying attention and are coming to the table to do that. And so, yeah I think the next couple years is going to be an exciting time. As we see all come to fruition. I think that it’s a delicate balance. Like we’re seeing so, so much innovation. Like I’m going to be the FHIR platform. No I’m going to be the FHIR platform. And to your point, it takes a bunch of different kinds of systems and we’re all going to have to be able to work together to make this thing fly.
It’s a terrific architectural problem to solve. And I don’t just mean technical architecture, but when I look at problems in business or in life, transitions are hard, right? Like transition from fall to spring, you never have the right coat on, you know, it’s cold when you think it’s going to be warm or you’re moving or you start a new job. Those are hard things. And what you just outlined is a lot of transitions of data, you know, data moving from one application to another in order to improve the clinician experience and improve the patient experience. And at all of those handoffs, between points of innovation, there’s this opportunity for the data ball to, to drop. And so the more we can simplify those transitions, I think the more that innovation can truly be accelerated. And unfortunately those transitions are often an afterthought. And so as we’re talking, I just, I urge healthcare technology solutions and providers who are adopting them to not dismiss the transition. To anticipate the transition, plan for it. Put the infrastructure in place, make the investment infrastructure, which I think is sexy. But most people don’t find infrastructure that sexy.
It’s not sexy, but it’s foundational. It’s like we bought a remodel a few years ago, a house. We spent the first couple of years fixing the foundation, you know, redoing the fireplace mortar, not fun projects, not like, oh, I have a beautiful kitchen now. More, oh my house is standing. It’s gonna stand up for a long time. And those weren’t not fun places to spend my money. But now when we’re fixing the kitchen and we’re remodeling the master, we are not dealing with surprises. We ran all new electrical. We ran all new plumbing. So those are, are not surprises that pop up in the middle of a project and slow us down. We’re not having to open drywall back up because we already did all of those things. And so I want people to approach the adoption of all of this innovation, the same way you would approach a remodel of a house. So you’re not ripping your drywall back open. You’re not getting consumers addicted to a personal health record and they’re so happy to have it. And then you have to shut it down because you can’t move the data the way that you need to. And you’ll bring it back later or you have to go to an upgrade or go to another application. Invest in the foundation, the infrastructure and build on top of it so that you have a really strong solution. Like you said, a couple years, those infrastructure managed service, we can have people up and running in four to six weeks and grow with you over time. And it just feels like when we’re talking, that feels like a way that organization can be really successful.
You know, it’s coming, be prepared. Yes
Very cool. Well, Michelle, it’s nice to talk to you today. Do you have anything else you wanna chat about?
No, this is great. I enjoy it. Thanks so much for thinking of this. Thank You for your time.