How low-code and openEHR are a winning combination for unlocking innovation in Healthcare

Electronic Health Records (EHRs) are the building blocks of modern healthcare systems.

The problem, however, is that current EHR systems were never designed to accommodate for the seamless data transfer between healthcare providers or the need for rapid digital innovation we see today.

New technological developments bring the promise of revolutionizing patient outcomes and accelerating successful research, but these are constrained by cumbersome systems that were never designed to keep up with the current pace of digital development. They also fail to meet patient expectations for data transparency and seamless care processes.

In this newsletter, we shine a light on this pernicious issue and point the way forward for medical organizations that want to continue striving for the best possible care – today and for the future.

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Closed systems are the root of the problem

Let’s be blunt: there is an over-reliance today on proprietary systems and a lack of standardization in medical data. This is the root cause of numerous issues, and it constrains innovation.

This is why:

• Existing EHR systems are costly, inflexible, and are unable to adopt new functionalities quickly.
• Suppliers of these systems simply cannot anticipate the innovations that medical researchers and clinicians have in mind.
• They’re provided as a ‘single package,’ which limits customization, or makes them very expensive and time consuming, and they come with serious vendor lock-in.
• Medical data is typically stored in siloed EHRs, where patient data and process data are all held in the same ‘closed’ system.

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As we strive to empower patients to manage their own data, these EHRs are clearly unable to meet our needs.

The only way forward is to revolutionize our approach to EHRs, and to build a new foundation that enables greater agility and digital innovation.

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A new vision for data-driven Healthcare

The Healthcare sector needs a unified and secure standard for Electronic Health Records (EHRs), as a foundation for future innovation.

This new foundational layer must incorporate a patient-centered standard, and accommodate national approaches to healthcare (such as the Dutch Vision and Strategy for Health Information Systems) as well as international initiatives and standards.

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This standard must:

• Enable open digitalization, by separating patient data and process data.
• Allow patients to access and manage their own data.
• Accommodate future innovations, including the ability to automate more than just administrative processes.
• Have enough flexibility to integrate diverse functionalities like remote health, automated ‘bedside expertise’, AI diagnostics, and other technologies that improve patient outcomes as well as productivity.
• Enable the free exchange of patient data, in case a person receives care in another country or medical institution.
• Allow anonymized data to be easily repurposed for demographic or epidemiological research.
• And process data must remain secure, so that only privileged access is allowed.

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OpenEHR: an international adopted and proven standard for digital innovation in Healthcare

To meet the growing needs for greater data portability across different Clinical Data Repositories, a new standard has come into being: openEHR.

After more than 15 years of development by the openEHR Foundation, openEHR is now used in several countries, including the United Kingdom, Sweden, and Finland. And with promising results.

It gives independence from specific applications or vendors and paves the way for more flexible digitalization in the Healthcare industry.

It supports multiple exchange formats including standards like HL7 and FHIR. And, because it is multilingual and complies with European guidelines, openEHR allows the secure exchange of patient data across national borders, as well as between institutions.

One of the most important aspects of openEHR is that it separates patient data from the process data of individual healthcare providers - a proper separation of these distinct concerns.

This means that patients can easily access their own data securely, and it facilitates the use of anonymized demographic data for secondary analysis or epidemiological studies.

Meanwhile, that precious process data remains ‘closed’ and secure.

OpenEHR is redefining the standard for digital healthcare by laying the groundwork for greater innovation. It’s flexible, scalable, and easy to adapt.

If a healthcare institution wants to add new capabilities or functionality to their systems, openEHR allows this.

And, with low-code technology it’s easier than ever to accelerate the pace of digital innovation in Healthcare and for each individual healthcare provider.

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The combined impact of low-code and openEHR

Low-code builds on the open standard that openEHR provides, to make your digital innovations a reality. It lowers the barrier for rapid innovations and the implementation of new functionalities.

Unfortunately, it’s all too easy to fall into the trap of limiting our thinking based on known paradigms - so the transformative potential of low-code is often overlooked.

This is especially true in a sector that is still dominated by vendors of commercial-off-the-shelf (COTS) systems and high-coded custom solutions.

The problem with many existing COTS

COTS have severe limitations that make it hard to achieve the versatility that openEHR can allow.?

Of course, COTS solutions do have some attractive qualities: they’re ready to use and they’re based on known standards.

However, as we’ve established, these standards are also a limitation when they do not allow segmentation of patient and process data and when data cannot be exchanged freely – as it needs to be.

COTS solutions also suffer from a high cost of ownership, and you end up paying for a full package of functionalities even when some may not apply to your situation.

When customization is needed, this adds cost and development time as well as an ongoing maintenance burden - if it’s possible at all.

Use cases outside the design parameters like cross-institutional collaboration or new processes are hard to manage (or impossible), and vendor lock-in is an issue.

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High coding isn’t much better

So perhaps the alternative to this would be a fully customized solution, built with ‘high coding’?

High code certainly gives you total freedom regarding functionality, but has other drawbacks, like a longer time to market and a reduced ease of maintenance. This reduces the impact that innovation can have as well as the flexibility needed concerning future changes.

Why low-code is the answer

Low-code is a perfect hybrid that combines the strengths of both COTS and high-coding, and none of the weaknesses.

It has a short time to market and, by using platforms that specialize in complex use-cases (like the USoft platform), you have a limitless ability to customize. You can build what you want, prototype and scale in a very short timeframe.

The cost of low-code is also very favorable, both in initial go-live and ongoing maintenance. In the case of the USoft platform, the total cost of ownership can be more than 40% lower than other solutions.

Furthermore, solutions built with low-code are easy to maintain and enable endless possibilities for forward-compatibility and integration of new processes.?

Business users can directly influence the product with their valuable input and collaborate closely with development teams.?

This shortens the time-to-value, and increases the overall value of the finished software, thanks to unlimited iterative improvements and added functionalities.

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What low-code means for Healthcare:

• Solutions can be built 10X faster, using visual modeling, building blocks, and automation.
• You have flexibility to continuously adapt to new needs, so new processes and technology innovations are easy to integrate.
• Using a suitable platform for complex use-cases, the total cost of ownership (TCO) for unique high-performance software can be far lower than COTS or high-coding.?
• Data quality and consistency can be significantly better. Solutions built with USoft have improved data consistency and accuracy by 50%.?
• You can build on the foundation of openEHR, to rapidly innovate and create new functionalities using standardized and open data.

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It should come as no surprise that Gartner predicts that 75% of new applications will be built with low-code - and that the vast majority of enterprises will use at least 4 different low-code tools.

When combined with openEHR, the possibilities for improving patient care are limitless.

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The combined strength of low-code and openEHR

Thanks to the open standard of openEHR, patient data is no longer institution-specific, but entirely standardized, open, and federated.

By using low-code, Healthcare professionals can build on this foundation to create ideal solutions. These can be tailor-made to each institution’s needs, and freely embrace the latest technological advancements.

From basic functions to complex AI implementations - it’s all possible, and in a very short timespan with low-code.

Quite simply, the combination of low-code with openEHR is a natural pairing.

It offers the convenience and reliability of standardization, with the total flexibility to build specific functionalities at speed. Moreover, it puts the clinicians themselves in the driver’s seat.

Want to learn more about the impact of low-code? See this use-case, integrating AI for automated phenotyping.?

For 30+ years, USoft has helped organizations to master the complexity of their unique operations. The USoft application development platform is used across every sector; from government to manufacturing, and from financial services to logistics. Learn more about the platform here.