Let's Federalize Healthcare!
It is not what you think it is
We all are aware of what is happening at Twitter. But, this is not about Twitter. This is about what that led me to.
Like, many other users I went to check out this new platform called Mastodon. It was the “replacement” for Twitter. Long story short it is not, but it is a platform I am loving so far!
It introduced me to the fediverse. It is fascinating. Imagine having one login and being able to interact with people on Instagram, Facebook, and Twitter. Maybe it is just the nerd in me but that to me is amazing. All of this is developed on top of the Activity Pub protocol. Activity Pub “provides a client to server API for creating, updating and deleting content, as well as a federated server to server API for delivering notifications and subscribing to content.”
What is an API?
API stands for application programming interface. In its most simple form, it allows different software to be able to easily send and or receive data. APIs are extremely important to our world. You’re surrounded by APIs but you don’t realize it, and that is the point.
Think of an API like transportation. As long as you have a vehicle that is road legal you can drive on the road and go anywhere that road goes. Now if you have a boat you will not be able to use that road unless you modify that boat. That is what an API does. It is the wheels and turn signals on a boat that allows you to use the road.
I am sure you can see how APIs would be extremely valuable in healthcare. Let’s go back to Mastodon. Mastodon is part of the “fediverse.” The majority of the applications on the fediverse run on top of the Activity Pup protocol and this allows them to communicate with each other. But, the best part of this is I can do it with ONE login. Imagine if you had to have a different car for every single place you had to go to. Thankfully we don’t need to. We can use the same car we have to go anywhere that the road will allow us to go.
How does the fediverse work?
I am glad you asked. The fediverse is filled with multiple communities called instances that operate on their servers. All these servers are connected via the activity pub protocol. Think of this as each server is a house in the neighborhood. Some are bigger than others and have more people in them but we all can go to each other’s houses and interact within our neighborhood. And just like your house, you can allow whoever you want in and you can keep the people you want to keep out. Just because you live in another house on the block does not mean you can’t hang out with your friends in other parts of the neighborhood or even the city.
There are hundreds of servers with people on them that can interact with any other server that is “federated.” This means that the server you are on is allowing itself to be discovered by other servers. Even if your server is federated you can still block other federated servers or even individuals altogether. But the key to all of this is the decentralized nature of all of this.
Now I know what you’re thinking. Here is another crazy person talking about web3 and decentralization. To that I say yeah I am one of those people that see the value of it. I will take it even further I think we should federate healthcare!
This is how we federate healthcare!
Let’s start with the basics. That is agreeing on a single protocol. Well, we are in luck! We already have something that has been being developed since the late 80s. It is called HL7 FHIR (Health Level 7 Fast Healthcare Interoperability Resources). HL7 is an organization “dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information…”
Does that sound familiar?
With HL7 FHIR you can communicate with any other application or server that is also using that protocol and easily retrieve data. Let’s say another protocol evolves. That is okay as long as we are on the same one or there are APIs that allow us to convert the data back and forth.
Once we have agreed on a standard, we can create a decentralized federated healthcare data exchange.
Healthcare facility to Healthcare facility
Each facility can have its server physically on-site or on the cloud and share data with other federated facilities. Again just because a facility is federated doesn’t mean it can access your data. Your system can block others. This would hopefully be used for bad actors and not rival systems because otherwise, the whole reason for doing this would be pointless.
Patient to Healthcare facility and vice versa
This is where I get excited. Patients could theoretically store their data on their servers and allow access of their data to their hospitals, PCP, specialists, etc. without regard to if they are in the system or not. Hell, they wouldn’t even have to be in the same country! This gives the data to their rightful owners which are the patients.
They would be the stewards of their data. You could set up an economy where the patient could sell their data to offset costs for their health conditions or just make some extra cash. I can go on and on about this topic and why I feel strongly about patients owning the right to their data. If there is interest I can touch on this in a future newsletter.
Population healthcare
Another great thing that can come out of all of this is the ability to perform population health. If all of the healthcare data is on a standard protocol then we should be in theory able to gather more accurate information and tackle population health issues much more efficiently.
To those who are not a fan of your data being used by centralized entities like the government. There are technologies where your data is stored in a privacy vault where all the data is encrypted and none of it is stored outside of that vault. This would allow statistics to be run and no one knows who you are. Then after they are done with it all the data is returned to your servers like nothing ever happened.
As you can see there are so many benefits to “federating” healthcare. Is it perfect? Absolutely not. Is it better than what is happening now? 100% yes!
Thank you so much for your support! Please do not hesitate to reach out if you have any questions or leave a comment.
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I hope you have a great day!