New FHIR API capabilities on Amazon HealthLake helps customers accelerate data exchange and meet ONC and CMS interoperability and patient access rules

Every hour, healthcare and life sciences organizations continuously generate large amounts of structured and unstructured health data from multiple systems, applications, and devices. Secure exchange and use of this data using interoperability standards such as Fast Healthcare Interoperability Resources (FHIR) can lead to better clinical decisions, clinical trials, and operational efficiency. To drive this transformation, the Office of the National Coordinator for Health IT (ONC) has required Electronic Health Records (EHRs) to make data available in the FHIR standard and in conformance with specific implementations. Additionally, the Centers for Medicare & Medicaid Services (CMS) is building reliance on those formats into its data sharing requirements for providers and payors.

However, implementing systems for these requirements can be challenging, as organizations have to rely on complicated data exports and implementation of complex application programming interfaces (APIs). Customers such as Electronic Health Record (EHR) vendors, Independent Software Vendors (ISVs), Systems Integrators (SIs), and IT teams working with healthcare organizations must manage the burden of building, operating, and maintaining FHIR servers and APIs as per the evolving regulatory requirements.

To address these pain points, we are excited to add three new capabilities to Amazon HealthLake’s managed FHIR API offerings. These capabilities make it easier for customers to build interoperability applications that conform to ONC and CMS interoperability and patient rules.

• SMART on FHIR: easily authorize users and third-party applications accessing FHIR data using OAuth2.0
• Patient access API: power patient and provider facing applications
• FHIR bulk data access: securely exchange health data among healthcare organizations through a bulk data access API

Amazon Web Services launched Amazon HealthLake in 2021 as a fully-managed HIPAA-eligible service for customers to securely store, transact, analyze, and exchange health data. Customers can store their data from diverse sources such as EHR systems, claims processing systems, laboratory information management systems, devices, and even social determinants of health (SDoH) data into a common interoperable format. Amazon HealthLake offers transactional FHIR APIs for customers to access this data to build interactive applications and interoperability workflows. Through HealthLake Analytics, customers can draw insights from this data with SQL on FHIR, build analytical dashboards to manage population health and quality measures, and train and deploy ML models for clinical decision support.

Capabilities to help customers meet interoperability-related ONC and CMS patient access rules

Reduce the burden of maintaining FHIR APIs with pay-as-you-go pricing

The launch of these three new capabilities benefits EHR system providers, ISVs, SIs, and IT teams working with healthcare organizations, by allowing them to simply leverage managed FHIR APIs to build interoperability applications or systems that conform to ONC and CMS patient access rules, reducing the burden of building and managing the underlying FHIR APIs and data store. These capabilities are available in a standard AWS pay-as-you-go pricing model, mitigating the need for  upfront capital investment.

Power a host of interactive patient and provider facing applications

Customers can use HealthLake FHIR APIs to power a host of interactive applications such as longitudinal medical record viewers for organizing patient medical history across various data modalities like clinical, imaging, and genomics. SMART on FHIR also enables third-party developers to build applications on top of FHIR data in a secure manner.

Zero ETL analytics on data

Customers can derive more value with their data using Amazon HealthLake. HealthLake Analytics module automatically transforms the transactional data in FHIR format into a flattened columnar format in Apache Iceberg tables for analytics. This saves customers time and effort in building and maintaining complex ETL pipelines. Customers can then use a set of AWS Analytics and AI/ML services (Amazon Athena, Amazon SageMaker) to analyze this data and unlock use cases such as SQL analytics on clinical data, population health, and clinical decision support. Customers can also seamlessly train ML models on their data or draw inference from their existing models for use cases such as disease prediction and risk stratification.

A great example of customers using these new capabilities is MEDHOST, which has been providing products and services to healthcare facilities of all types and sizes for over 35 years with the goal of enhancing patient care and operational efficiency through clinical and financial solutions and services. This includes a fully integrated EHR solution and a comprehensive emergency department information system.

“We’re excited to leverage Amazon HealthLake FHIR APIs to accelerate our interoperability charter and help our customers conform to CMS interoperability and patient access rules. Amazon HealthLake’s managed service reduces the burden to build and maintain underlying FHIR APIs and infrastructure. This lets us focus on rapidly building innovative applications for our customers. 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.” – Pandian Velayutham, Sr. Director of Engineering at MEDHOST.

Similarly, leading EHR Greenway Health plans to leverage Amazon HealthLake to accelerate innovation across their products.

“Greenway Health is excited to leverage Amazon HealthLake to accelerate delivery of innovative solutions to our clients. HealthLake’s managed service enables Greenway to focus more of our research and development resources directly on value-add healthcare innovation. 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.” – David Cohen, Chief Product and Technology Officer at Greenway Health.

An easier way to share health data

These new enhanced capabilities include SMART on FHIR authorization, Patient Access API, and FHIR Bulk Data Access API. These capabilities give customers the ability to share their data with authorized stakeholders with enhanced interoperability that helps customers meet the latest ONC and CMS regulatory standards including HL7 FHIR API R4 v4.0.1, FHIR Bulk Data Access v2.0.0, US Core IG STU v3.1.1, HL7 SMART App Launch Framework IG v1.0.0, and integrate with OAuth 2.0 & OpenID Connect.

SMART on FHIR

SMART on FHIR provides reliable and secure authorization for applications integrating with the OAuth 2.0 standard. Customers and partners building SMART on FHIR applications can control access to data and deploy fine-grained access control to ensure authorized access to resources. ISVs can empower a community of third-party developers building clinical applications that enhance user experience without compromising security. App developers can innovate and provide their users with the right information at the right time, such as notifying clinicians when patient laboratory results become available so that they can provide better care.

Patient Access API

Customers can use Amazon HealthLake to share data securely by implementing APIs like Patient Access API to build patient and provider facing applications that foster information exchange and improve patient care while reducing costs. Amazon HealthLake validates FHIR resources according to US Core, CARIN for Blue Button profiles, which enable a broad set of interoperability capabilities. ISVs and their customers can take advantage of these APIs and FHIR resource validation to facilitate efficient exchange of health information to coordinate care, provide timely and correct reimbursement, and empower patients to fully participate in their care.

FHIR Bulk Data Access APIs

When customers need to transfer a large number of resources, like facilitating payor to payor 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. Payors can take advantage of this feature to transmit large data sets to support population health management, and health systems can use Bulk Data Access to populate their analytics and research data stores to inform better clinical decisions.

Amazon HealthLake SMART on FHIR, patient access API, and FHIR bulk data API export capabilities are currently available in preview. We will update when these capabilities become generally available along with revised pricing. These new capabilities will be available in all regions where Amazon HealthLake is generally available, including US East (Northern Virginia), US East (Ohio), US West (Oregon), and Asia Pacific (Mumbai) regions.

Conclusion

Amazon HealthLake helps healthcare and life sciences customers improve the way they use patient and population-level data to better inform clinical decisions, design effective clinical trials, and improve operational efficiency. With enhanced FHIR capabilities, Amazon HealthLake helps customers use a fully- managed service to meet the latest ONC and CMS regulatory standards while achieving interoperability.