Connected Healthcare Data: Interoperability to Solve Fragmentation and Drive Better Patient Outcomes

Jeff Needham and Miquel Nieto
May 26, 2022 | Updated: July 25, 2022

Many differences exist across healthcare systems around the globe, but there is one unfortunate similarity: fragmentation. Fragmentation is a consequence of the inability of various healthcare organizations (both public and private) to communicate with each other or to do so in a timely or consistent manner, and it can have a dramatic impact on patient and population well-being.

Interoperability and communication

A patient can visit a specialist for a specific condition and the family doctor for regular checkups, perhaps even on the same day. But how can both doctors make appropriate decisions if patient data is not shared between them?

Fragmented healthcare delivery, as described in this scenario, also leads to data fragmentation. Such data fragmentation can cause misdiagnosis and services duplication. It can also lead to billing issues, fraud, and more, causing preventable harm and representing a massive economic burden for healthcare systems worldwide.

To improve healthcare fragmentation, we need truly interoperable health data.

The longitudinal patient record

A longitudinal patient record (LPR) is a full, life-long view of a patient’s healthcare history and the care they’ve received. It’s an electronic snapshot of every interaction patients have, regardless of provider and service. Ideally, this record can be shared across any or all entities within a country’s healthcare system. The LPR represents a step beyond the electronic health record, extending past a specific healthcare network to a regional or national level.

It’s critical that LPRs use the same data format and structure to guarantee the ability of healthcare providers to easily and quickly interact with them. Data standards for LPRs are key to interoperability and can help address healthcare fragmentation, which, in turn, can help save lives by improving care.

FHIR

Fast Healthcare Interoperability Resources (FHIR) is a commonly used schema that comprises a set of API and data standards for exchanging healthcare data. FHIR enables semantic interoperability to allow effective communication between independent healthcare institutions and essentially defines “how healthcare information can be exchanged between different computer systems regardless of how it is stored in those systems” (ONC Fact Sheet, “What is FHIR?”).

FHIR aims to solve the fragmentation problem of the healthcare system by directly attacking the root of the problem: miscommunication.

As is the case for many other modern communication standards (for example, ISO 20022 for finance), FHIR builds its REST API from a JSON schema. This foundation is convenient, considering most modern applications are built with object-oriented programming languages that have JSON as the standard file and data interchange format. This approach also makes it easier for developers to build applications, which is perhaps the most important point: The future of healthcare delivery may increasingly depend on the creation of applications that will transform how patients and providers interact with healthcare systems for the better.

MongoDB: FHIR and healthcare app-ification

MongoDB is a document database and is therefore a natural fit for building FHIR applications. With JSON as the foundation of the MongoDB document model developers can easily store and retrieve data from their FHIR APIs to and from the database, with no translation or change of format needed. In fact, organizations can adopt FHIR resources as the basis of a new, canonical data model that existing internal systems can begin to shift and conform to.

One example is the Exafluence FHIR API, which is built on top of MongoDB. Exafluence's API allows for real-time data interchange by leveraging Apache Kafka and Spark, in either an on-premise or multi-cloud deployment. Software teams leveraging the Exafluence solution have experienced velocity increases of their FHIR interoperability projects by 40% to 60%.

MongoDB's tool set can develop value-add business solutions on the FHIR-native dataset — without ETL.

Beyond FHIR, the trend toward healthcare app-ification (i.e., the increasing use of applications in healthcare) clashes with pervasive legacy architectures, which typically are not optimized for the developer experience. Because of this reliance on legacy architectures, modernization or transformation initiatives often fail to take hold or are postponed as companies perceive the risks to be too high and the return on investment is not evident.

It doesn’t have to be this way, however. MongoDB’s industry-proven iterative approach to modernization reduces the risk of application and infrastructure migration and unlocks developer productivity and innovation.

Interoperable, modern healthcare applications can now be built in a developer-friendly environment, with all the benefits expected from traditional databases (i.e., ACID transactions, expressive query language, and enterprise-grade security). MongoDB provides the freedom for solutions to be deployed anywhere (e.g., on-premises, multi-cloud), providing a major advantage for healthcare organizations, which typically have multi-environment deployments.

Healthcare and the cloud

Digital healthcare will accelerate the adoption of cloud technologies within the industry, enabling innovation at scale and unlocking billions of dollars in value. Healthcare organizations, however, have so far been reluctant to move workloads to the cloud, mostly because of data privacy and security concerns.

To support such cloud adoption initiatives, MongoDB Atlas offers a unique multi-cloud data platform, integrating MongoDB in a fully managed environment with enterprise-grade security measures and data encryption capabilities. MongoDB Atlas is HIPPA-ready and a key facilitator for GDPR compliance.

A holistic view of patient care

Interoperable healthcare records and communication standards will make longitudinal patient records possible by providing a much-sought-after holistic view of the patient, helping to fix healthcare fragmentation. Many challenges still exist, including transforming legacy infrastructures into modern, flexible data platforms that can adapt to the exponential changes happening in the healthcare industry. MongoDB provides a developer data platform designed to unlock developer productivity and ultimately giving healthcare organizations the power to focus on what matters most: the patient.

Read Part 2 of this series on connected healthcare data, and learn more about MongoDB Atlas and the healthcare industry.

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From Tamagotchi Pets to IoT Factories: Digging In at MongoDB World’s Builder’s Fest

Everyone loves to build — whether it’s a child playing with LEGO Bricks or a startup founder building an app from scratch. At MongoDB World 2022 , attendees will have the chance to build something truly unique. Builder’s Fest, which takes place on June 9, 2022, at MongoDB World in New York, gives attendees the opportunity to get involved in hands-on workshops and coding competitions. The event will help developers learn how to master features of MongoDB — and also have a lot of fun. “Builder’s Fest is a place where builders get together and feed off each other’s vibes and collaborate,” says Karen Huaulme, a principal developer advocate at MongoDB. “People are coming in from all different levels; we have something for everyone.” A session at Builder’s Fest at MongoDB World 2019. “At Builder’s Fest, we get our hands dirty and see MongoDB in action,” says MongoDB principal consulting engineer Dawid Esterhuizen. MongoDB experts will lead workshops and coding competitions to showcase their work, show off their skill sets, and reveal their secret passions. After more than two years of remote conferences, these engineers are excited to build something in person, together with colleagues and peers. After delivering his keynote earlier in the week, MongoDB CTO Mark Porter will host four sessions during Builder’s Fest. Porter’s four sessions are: MongoDB’s Architectural Advantages , Safe Software Deployments , Engineering Culture at MongoDB , and Is Relational the New COBOL? Builder’s Pods Attendees at Builder's Fest 2019 gather around to share different ideas with each other. Much of the action at Builder’s Fest takes place in the Builder’s Pods, which will be spread throughout MongoDB World’s Partner Promenade. The Pods are set up for hands-on learning and tutorials, and they will host the mini workshops led by MongoDB experts and others. David Bradford is an engineer at MongoDB who is hosting a session in the Builder’s Pod. “For Builder’s Fest, I’m really excited to see the breadth of ways that MongoDB can be used to build unique and novel tooling and solutions,” he says. Bradford’s session will detail how to use MongoDB to export Git history. “I’m looking forward to showing off some exploration I have been doing around leveraging MongoDB to explore trends and patterns hidden in Git repositories,” Bradford says. “I’m excited to be able to show how features like the aggregation framework and MongoDB Atlas Charts can be used to quickly build powerful analysis tools.” During 2019’s Builder’s Fest, some of the Builder’s Pod topics included using MongoDB Atlas and Stitch, getting a Raspberry Pi to send IoT data to MongoDB, and creating visualizations using MongoDB Charts. New sessions this year will begin every half hour at each pod around the space. Workshops will cover a wide spectrum, from building custom Tamagotchi hardware to tinkering with our model-size IIoT smart factory. John Page, a distinguished engineer at MongoDB, is hosting the session on building custom Tamagotchi hardware. “I'm excited to show off my passion projects and to introduce people to the joy of coding for tiny computers,” Page says. “If you’ve never programmed hardware directly before, you get a chance to try it.” Says Dawid Esterhuizen, a principal consulting engineer at MongoDB: “I plan to visit the IoT and Tamagotchi pods as my first stop. I like getting involved in the technical bits," he says, "and at Builder’s Fest we get our hands dirty and see MongoDB in action.” The security topics are always of interest, Esterhuizen says, as well as the various coding challenges. At Builder’s Fest, there really is something for everyone. On two large stages at either end of the Partner Promenade, MongoDB World 2022 participants can take part in coding challenges and gaming competitions. Attendees can go head-to-head and show off their skills. Coding experts and gamers will not want to miss out on this electric activation on Day 3 of MongoDB World. Builder’s Fest will run from 11 a.m. to 3 p.m inside the Partner Promenade. Be sure to check out the full Builder’s Fest agenda within the MongoDB World app for iOS or Android to find workshops that are right for you. Register today for MongoDB World, and use code ​​MDBW22BLOG to save 25% off your tickets. We hope to see you in NYC from June 7 to June 9!

May 26, 2022
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Hanabi Technologies Uses MongoDB to Power AI Assistant, Hana

For all the hype surrounding generative AI, cynics tend to view the few real-world implementations as little more than “fancy chatbots.” But for Abhinav Aggarwal, CEO of Hanabi Technologies, the idea of a generative AI-powered bot that is more than just an assistant was intriguing. “I’d been using ChatGPT since it launched,” said Aggarwal. “That got me thinking: How could we make a chatbot that was like a team member?” And with that concept, Hana was born. The problem with bots “Most generative AI chatbots do not act like people; they wait for a command and give a response,” said Aggarwal. “We wanted to create a human-like chatbot that would proactively help people based on what they wanted—automating reminders, for example, or fetching time zones from your calendar to correctly schedule meetings.” Hanabi’s flagship product, Hana, is an AI assistant designed to enhance team collaboration within Google Chat, working in concert with Google Workspace and its suite of products. “Our target customers are smaller companies of between 10 and 50 people. At this size you’re not going to build your own agent from scratch,” he said. Hana integrates with Google APIs to deliver a human-like assistant that chimes in with helpful interventions, such as automatically setting reminders and making sure meetings are booked in the right time zone for each participant. “Hana is designed to bring AI to smaller companies and help them collaborate in a space where they are already working—Google Workspace,” Aggarwal explained. The MongoDB Atlas solution For Hana to act like a member of the team, Hanabi needed to process massive amounts of data to support advanced features like retrieval-augmented generation (RAG) for better information retrieval across Google Docs and many other sources. And with a rapidly growing user base of over 600 organizations and 17,000+ installs, Hanabi also required a secure, scalable, and high-performing data storage solution. MongoDB Atlas provided a flexible document model, built-in vector database, and scalable cloud-based infrastructure, freeing Hanabi engineers to build new features for Hana rather than focusing on rote tasks like data extract, transform, and load processes or manual scaling and provisioning. Now, MongoDB Atlas handles a variety of responsibilities: Scalability and security: MongoDB Atlas’s auto-scaling and automatic backup features have enabled Hanabi to seamlessly grow its user base without the need for manual database management. RAG: MongoDB Atlas plays a critical role in Hana’s RAG functionality. The platform enables Hanabi to split Google Docs into small sections, create embeddings, and store these sections in Atlas’s vector database. Development Processes: According to Aggarwal, MongoDB’s flexibility in managing changing schemas has been essential to the company’s fast-paced development cycle. Data Visualization: Using MongoDB Atlas Charts has enabled Hanabi to create comprehensive dashboards for real-time data visualization. This has helped the team track usage, set reminders, and optimize performance without needing to build a manual dashboard. Impact and results With MongoDB Atlas, Hanabi can successfully scale Hana to meet the demands of its rapidly expanding user base. The integration is also enabling Hana to offer powerful features like automatic interactions with customers, advanced information retrieval from Google Docs, and manually added memory snippets, making it an essential tool for teams around the world. Next steps Hanabi plans to continue integrating more tools into Hana while expanding its reach to personal Gmail users. The company is also rolling out a new automatic-interaction feature, further enhancing Hana’s ability to proactively assist users without direct commands. MongoDB Atlas remains a key component of Hanabi’s stack, alongside Google Kubernetes Engine, NestJS, and LangChain, enabling Hanabi to focus on innovating to improve the customer experience. Tech Stack MongoDB Atlas Google Kubernetes Engine NestJS LangChain Are you building AI apps? Join the MongoDB AI Innovators Program today! Successful participants gain access to free MongoDB Atlas credits, technical enablement, and invaluable connections within the broader AI ecosystem. If your company is interested in being featured, we’d love to hear from you. Connect with us at ai_adopters@mongodb.com.

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