AWS this week announced three new enhanced FHIR features for Amazon HealthLake that offer health IT clients a fully-managed service to meet some of the most recent interoperability standards from the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT.

WHY IT MATTERS

The new capabilities make it easier for healthcare organizations to leverage data from multiple systems, applications and devices to build interoperability applications that conform to ONC and CMS rules, according to Wednesday's announcement from AWS.

Amazon HealthLake, a HIPAA-eligible service for secure data storage, analytics and exchange, now enables customers to share their data with authorized stakeholders without complicated data exports and implementation of complex APIs. 

The goal is to reduce the burden of building and managing the underlying FHIR APIs and data store. 

With SMART on FHIR, HealthLake customers can more easily authorize users and third-party applications to access FHIR data using OAuth2, control access to data and deploy fine-grained access control to ensure authorized access to resources, according to AWS.

HealthLake FHIR APIs can power interactive applications such as longitudinal medical-record viewers for organizing patient medical history across various data modalities, such as clinical, imaging and genomics, the company says. 

The Patient Access API on HealthLake allows EHR vendors and other health IT developers to create patient- and provider-facing applications that coordinate care, improve operations and empower patients to connect with their care plans with information exchanged on validated FHIR resources.

When customers need to transfer a large number of resources, like facilitating payer-to-payer data exchange, they can utilize Amazon HealthLake’s FHIR Bulk Data Access API to securely export data for all patients, a subset of patients or all FHIR data stored in Amazon HealthLake. 

Payers can also take advantage of this feature to transmit large data sets to support population health management while healthcare systems can use it to populate analytics, AWS notes.

The HealthLake Analytics module can automatically transform transactional data in FHIR into a flattened columnar format in Apache Iceberg tables, saving time and effort in building and maintaining complex data pipelines, the cloud provider says. 

AWS Analytics and AI/ML services can then analyze the data and unlock use cases such as SQL analytics on clinical data, population health and clinical decision support. They can also train large language models on their own data, or draw inferences from their existing models for use cases such as disease prediction and risk stratification.

Greenway Health is one company that says it plans to leverage Amazon HealthLake to accelerate innovation.

"HealthLake’s managed service enables Greenway to focus more of our research and development resources directly on value-add healthcare innovation," said David Cohen, chief product and technology officer at Greenway, in the AWS announcement.

"Integrated domain-specific AWS capabilities including Comprehend Medical, HealthLake Analytics and AI/ML tools open up a new realm of opportunity for us to deliver value for our clients," he said.

Amazon HealthLake's SMART on FHIR, patient access API and FHIR bulk data API export capabilities are currently available in preview in all regions where Amazon HealthLake is generally available, says AWS.

THE LARGER TREND

Under the 21st Century Cures Act, Bulk FHIR Access APIs "must also be accessible in all certified health IT" so that any organization using an EHR can access the full United States Core Data for Interoperability dataset on their populations. 

Secure exchange using FHIR – flexible to both document level and data level exchange – can lead to better clinical decisions, clinical trials and operational efficiency.

Because wider adoption of Bulk FHIR can improve an array of healthcare uses, from population health management and care coordination to health equity, across networks, a number of organizations, including ONC, formed a new coalition in April to spur wider use. 

With Bulk FHIR Access APIs, "physicians and ACOs can access claims data on their populations for use in treatment," and develop other new approaches to quality measurement, said Dr. Kenneth Mandl, a clinical informatics leader with Harvard Medical School.

The APIs open up access to patient-level data across a patient population with "push-button access," he told Healthcare IT News ahead of his HIMSS23 presentation. 

ON THE RECORD

"Amazon HealthLake’s managed service reduces the burden to build and maintain underlying FHIR APIs and infrastructure," said Pandian Velayutham, senior director of engineering at MEDHOST, another AWS client, in a statement.

"This lets us focus on rapidly building innovative applications for our customers," he said. "We are also actively collaborating with AWS to explore Amazon Comprehend Medical, HealthLake Analytics and other AI/ML tools to build innovative applications, reduce operational burden for our customers and help improve the overall quality of care."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.