We’re all in this together: Connecting the Dots to Create a Patient-Centric Healthcare System That Works  

Here we are in 2024: another trip around the sun. I, like so many of you, have found myself pensive and reflective over the past few weeks, on one hand proud of what I have done in this last year and on the other anxious about that lingering handful of hopes left unfulfilled. Rested and rejuvenated, I am eager about the future, about another chance at bat.

This same dreaming is happening at an organizational level here at 1upHealth (because, of course, corporations are people, my friend). With pride, we look back at what we have done as a company since Patient Access materialized in 2020. With excitement, we look forward to another chance to improve healthcare as we anticipate updated regulatory guidance from CMS dropping: another turn at the crank for FHIR and interoperability.

Against this backdrop, the ONC recently announced the final HTI-1 rule (Rule to Advance Health IT Interoperability and Algorithm Transparency). And after years of anticipation, the first official QHINs as part of TEFCA were finalized. Years of planning are starting to pay off in the healthcare industry across so many different axes.

I am not so myopic that I think that FHIR is the long awaited panacea to all of healthcare’s woes, despite what you may think after reading my previous blog post. Like so many of us, my lot in life is to vacillate between hopeful optimism and crushing pragmatism. Change – any change, good or bad, takes time. Even those moments of seemingly sudden, stark inflection often have a long lead up that simmers beneath the surface for those who have the wherewithal to look to find.

Case in point, as I sit here and type this, my computer is plugged into a surge protector from the mid nineties. (I actually am pretty sure it is from the early nineties, but I want to be a reliable storyteller so I’m baking in a bit of a factor of safety.) Three weeks ago as I moved into a new home with the help of my father, I jokingly asked if he remembered that surge protector and if it was time to retire it. His response? “Keep using it. I still have one too, and it’s still going strong.” (The craziest thing? A quick internet search reveals that they still sell this same model – the Isotel Ultra 8 – today!)

Just because you can doesn’t necessarily mean that you should. This is a journey that we are all on together. Every person and every organization needs to run at their own pace. And while we are sometimes quite polarized because of the passion we all have for making the world a slightly better place than it was when we first found it, there is a subtle but acute danger in getting too weighed down by ideological purity. Any collaboration is better than no collaboration at all. We may walk at different paces, with different gates, along different routes, but our collective destination is the same. When we all converge, it is our duty to ourselves and to the humanity of others to make sure everyone arrives safely. We’re all in this together, so we must support one another throughout the trek.

My partner and I have been together since 2009. I first met her parents not long after that. At the time, they were quite proud not only that they had yet to lean into the burgeoning trend of the smartphone but also that they had managed to resist the shift to cell phones with physical keyboards which was peaking at the time. They were proud of their flip phones. There was a strict “no phones visible” rule at the table. They rolled their eyes every time “us kids” pulled our iPhones out to look something up as our random intellectual curiosities arose. You obviously know where this story is going. Today my wife and I are the ones harassing them to put their phones down while we are eating. And I myself am the one lambasting others about the damage that constant connectivity is wrecking on society. Change takes time. And inevitably over time, we all do change.

At 1upHealth, we know that FHIR will change the world. And wherever you are in your own personal quest to fix the healthcare system – however you feel about FHIR – there is an open seat at our table for you, and we eagerly welcome you to sit down with us in collaboration and fellowship.

The big picture answer is easy. Deliver better care. Spend less money. Work smarter, not harder. Use data to make better decisions. Synergy. Integration. Digital transformation. Well, at least the big picture buzz words are easy to say. But the nuance of actualizing a revolution in healthcare is, in fact, quite encumbering and very intricate. So the challenge for all of us in this world of unlimited wants with limited resources is prioritization and focus. We here at 1upHealth are not trying to solve every problem, and you should not be trying to do so either. The trick, of course, is to play to your strengths and to have a team around you that can help you out where you don’t excel.

Even if we zoom into just healthcare data interoperability and the associated value chain, there are multiple steps, all of which are important and each of which are distinctly specialized. One such view of things might be: acquisition, standardization, normalization, integration, application. Or in other words, getting groceries from multiple vendors, splitting up large cuts of meat into smaller, more manageable chunks, separating goods destined for the fridge/freezer/pantry/basement, finding space in your home to actually store said groceries, remembering those ingredients so you can actually include them in a meal. All critical steps. All different steps. Steps that may not make sense to all have the same owner.

There were a multitude of ways to share healthcare data before my surge protector was first manufactured. There are even more now. And I suspect that this cornucopia of interoperability pathways will persist long after my trusty Isotel Ultra 8 stops protecting me from surges. But if we are to put all of this bountiful information to any use whatsoever, the ability to standardize, to normalize, to integrate, and to apply that data to a given use case is critical. So wherever you are getting your data from, however that data is getting to your doorstep, I invite you to think about 1upHealth as a strategic partner in realizing value from that data.

With a modern tech stack in the cloud and a modular platform of assorted tooling, 1upHealth is using FHIR as a catalyst to revolutionize the industry. But most chemical reactions will not run with just a catalyst alone. And so we welcome all the other players in the space into our big tent to join us with their bounties.

Provider systems with your robust HL7 v2 infrastructure, welcome. 

HIEs with ADTs and CCDAs, welcome. 

QHINs riding on the rails of TEFCA, welcome. 

1upHealth is excited to be an aggregator, a translator, a broker, a storer, a deliverer. We are here to help with the last mile. We are here to help you finish the job.

I’ve got a seat here at the table, next to my father-in-law, just for you. If you can get him to put his iPhone down for a moment, you’ll find in him some lovely conversation. And I have a succulent meal prepared, loaded up with an array of fun and zesty ingredients. I can’t wait to break bread together as we talk about how we make the world a better place. It’s not just hopeful optimism. It’s our duty. Because we each have just one life and just one earth to share, and we’re all in this together.

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