Industry executives and experts share their predictions for 2022.  Read them in this 14th annual VMblog.com series exclusive.

Healthcare will achieve greater interoperability through self-service and automation

By Ruby Raley, VP of Healthcare and Life Sciences at Axway

The last two years have brought a dramatic new reliance on digital healthcare - it was a necessity, yes, but also a long time coming. Going into 2022, I believe we'll see all these different pieces that needed to be stood up in record time being brought together to ultimately offer a better patient experience.

For example, price transparency in healthcare has the potential to revolutionize patient care, and major changes are coming as new regulations roll out. Enterprises that are well along their digital transformation journey are attaining new levels of maturity, which brings increased complexity. To avoid becoming bottlenecked by siloed business operations, poor automation, and accruing technical debt, healthcare partners should navigate this complex regulatory landscape with an API-first approach.

Need to retire Tech Debt

The need to retire Tech Debt is going to be front and center for CIOs.  With inflation, staff issues (great resignation and burn out), etc., CIOs will need to find operational efficiencies to fund new projects.  One of these steps will be tech consolidation to reduce maintenance spend.

While working to retire and consolidate apps, organizations can build stronger integrations by putting APIs on legacy applications, extending their life and getting them off islands of automation. In healthcare especially, today's challenges will require a new approach that is "low-code" to orchestrate human and machine processes.

Low-code is shorthand for an application development environment that is primarily visual and uses simple declarative statements to create applications. This will allow teams to accelerate program delivery. 

And accelerated program delivery is key right now for healthcare IT teams that are stretched thin as they respond to growing regulatory demands in 2022: the U.S. government delayed enforcement of some interoperability regulations during the pandemic, but new deadlines are fast approaching.

Self-Service and Process Automation

Self-Service and Process Automation are starting to peak now, but these are going to get stronger as CIOs look for ways to improve consumer, partner and developer experience and streamline processes.

For example, health plans currently need to scale solutions to meet the demands of the Interoperability Rule, 21st Century Cures Act. The challenge is extensive, from enabling self-service connectivity, providing robust security & audit, to scaling up to meet a difficult-to-estimate traffic volume. Self-service and automation are the clear answer to minimizing the impact on staff and systems.

Organizations that continue to think in terms of single projects will not be able to go as fast as U.S. regulatory timelines will require them to go. Instead, they should implement a strategy that gives them building blocks to reuse over and over - where developers will be empowered with the convenience of self-service and automation.

Game-changing FHIR Patient Access API

The regulatory compliance date for the CMS Interoperability and Patient Access Final Rule came and went in 2021. But we see that the industry is looking beyond compliance dates and understands the need to move project-based integrations to self-service integrations.

Changing from a compliance mindset, with an 18-month or six-month project sprint, to a composable ecosystem of built components will help healthcare partners get to an advanced explanation of benefit or price estimator faster as additional interoperability regulations roll out.

We can take an example of building a price estimator: with reusable building blocks, organizations can grab the provider directory and their price book. They see that the IDs are related, so they can correlate this and make this view available with an experience/process API (composite API, grouping APIs to form a unit of work or simplify processing) for the price estimator. They choose the provider, find the price. Then, they can add that all up on the web screen or the mobile app and provide an option to have the information delivered electronically via FHIR API or as a file in a human-readable format. Note that both the human and electronic experience use the same foundational APIs.

Organizations that start thinking about this as exposing APIs and opening up their systems can end up in what we're calling a composable ecosystem. It's low-code, API-first thinking. They have their components, and backed up by robust security and authorization, they are able to build this much more easily and faster than having to go to the source system.  Think of it as a library of components that can be easily discovered, leading to faster development at lower cost.

There is an immense opportunity to transform how healthcare works with its partners - and a more modulable healthcare company is going to be a major competitive advantage. A report this summer found only 5.6% of hospitals are compliant with the price transparency rule: clearly, rollout is far from over. As organizations adopt solutions that will help them make price transparency a reality, they'll be able to empower people to make informed health care decisions in 2022 and beyond.

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ABOUT THE AUTHOR

Ruby Raley, VP of Healthcare and Life Sciences at Axway

Axway helps over 11,000 customers revitalize their heritage IT infrastructure to digitally transform and grow. With Amplify - the only open, independent API management platform available anywhere - we help companies move forward faster and create brilliant digital experiences. Our MFT and B2B integration solutions have been trusted for 20 years. Raley's team drives API and Digital Transformation sales in North America. She is also a Consultant and Advisory Board Member helping launch Axway products, improve processes, and position solutions.