Cloud Providers Reaffirm Commitment to Open Healthcare Interoperability During 2019 Blue Button Developers Conference

WASHINGTON - Today a group of technology leaders from Amazon, Google, IBM, Microsoft, Oracle and Salesforce came together at the CMS Blue Button 2.0 Developer Conference to reaffirm a commitment to interoperability made one year ago, and to share progress and plans to move decisively forward on this pledge.

Read the commitment below, followed by quotes from cloud provider leaders:

As healthcare evolves across the globe, so does our ability to improve the health and wellness of communities. Patients, providers, and health plans are striving for more value-based care, more engaging user experiences, and broader application of machine learning to assist clinicians in diagnosis and patient care.

Too often, however, patient data are inconsistently formatted, incomplete, unavailable, or missing - which can limit access to the best possible care. Equipping patients and caregivers with information and insights derived from raw data has the potential to yield significantly better outcomes. But without a robust network of clinical information, even the best people and technology may not reach their potential.

Industry leaders being honered for the contributions to Blue Button and FHIR during conference. Credit Office of the HHS CTOInteroperability requires the ability to share clinical information across systems, networks and care providers. Barriers to data interoperability sit at the core of many process problems. We believe that better interoperability will unlock improvements in individual and population-level care coordination, delivery and management. As such, we support efforts from ONC and CMS to champion greater interoperability and patient access.

This year's proposed rules focus on the use of HL7® FHIR® (Fast Healthcare Interoperability Resources) as an open standard for electronically exchanging healthcare information. FHIR builds on concepts and best-practices from other standards to define a comprehensive, secure and semantically-extensible specification for interoperability. The FHIR community features multidisciplinary collaboration and public channels where developers interact and contribute.

We've been excited to use and contribute to many FHIR-focused, multi-language tools that work to solve real-world implementation challenges. We are especially proud to highlight a set of open-source tools including: Google's FHIR protocol buffers and Apigee Health APIx, Microsoft's FHIR Server for Azure, Cerner's FHIR integration for Apache Spark, a serverless reference architecture for FHIR APIs on AWS, Salesforce/Mulesoft's Catalyst Accelerator for Healthcare templates, and IBM's Apache Spark service.

Beyond the production of new tools, we have also proudly participated in developing new specifications including the Bulk Data $export operation (and recent work on an $import operation), Subscriptions, and analytical SQL projections. All of these capabilities demonstrate the strength and adaptability of the FHIR specification. Moreover, through connectathons, community events, and developer conferences, our engineering teams are committed to the continued improvement of the FHIR ecosystem. Our engineering organizations have previously supported the maturation of standards in other fields and we believe FHIR version R4 - a normative release - provides an essential and appropriate target for ongoing investments in interoperability.

We have seen the early promise of standards-based APIs from market leading Health IT systems, and are excited about a future where such capabilities are universal. Together, we operate some of the largest technical infrastructure across the globe serving many healthcare and non-healthcare systems alike. Through that experience, we recognize the scale and complexity of the task at hand. We believe that the techniques required to meet the objectives of ONC and CMS are available today and can be delivered cost-effectively with well-engineered systems.

At Amazon, Google, IBM, Microsoft, Oracle, and Salesforce, we are fortunate to work with many teams and partners that draw on experiences across industries to support and accelerate the delivery of FHIR APIs in healthcare. Moreover, we are committed to introducing tools for the healthcare developer community. After the proposed rule takes effect, we commit to offering technical guidance based on our work including solution architecture diagrams, system narratives, and reference implementations to accelerate deployments for all industry stakeholders. We will work diligently to ensure these blueprints provide a clear and robust path to achieving the spirit of an API-first strategy for healthcare interoperability.

As a technology community, we believe that a forward-thinking API strategy as outlined in the proposed rules will advance the ability for all organizations to build and deploy novel applications to the benefit of patients, care providers, and administrators alike. ONC and CMS's continued leadership, thoughtful rules, and embrace of open standards help move us decisively in that direction.

Signed,

Amazon, Google, IBM, Microsoft, Oracle, and Salesforce

"As patients navigate the healthcare system, their records should be easily transferrable between all organizations to ensure continuity of care. In collaboration with customers and partners such as Change Healthcare, Cloudticity, Cerner, and Black Pear Software, AWS enables the interoperability of healthcare data by offering secure, scalable solutions to support a patient-centric approach. We see open standards interoperability tools, like FHIR, as building blocks that can improve the 21st century patient experience. We hope to see FHIR spark innovation in the healthcare space to reduce costs, increase access, and improve health outcomes." Says Dr. Taha A. Kass-Hout, MD, MS, Director of Healthcare and Chief Medical Officer, AWS Public Sector.

"At Google Cloud, we remain committed to enabling interoperability of healthcare data," said Aashima Gupta, Director of Healthcare, Google Cloud.

"We are very proud to join stakeholders in the technology community to help create solutions for the adoption of open standards and technologies for healthcare data interoperability. Cloud led transformation provides a holistic strategy to enable interoperability at scale and help break down healthcare data silos to deliver better patient outcomes at lower costs across the entire health ecosystem."

"At IBM, we strongly believe that all citizens have a right to improved information flow between the various clinicians they see. In my opinion, improved interoperability will fundamentally revolutionize healthcare by improving population-level care, coordination, delivery and management. And in order to achieve this goal, we need public-private partnerships that simplify sharing and re-align incentives across stakeholders. It is with that mindset that we are proud to join our cloud technology peers - Amazon, Google, Microsoft, Oracle and Salesforce -- in applauding the efforts of the Office of the National Coordinator for Health Information Technology and Centers for Medicare & Medicaid Services to advance safe and secure consumer-centric information sharing across the health ecosystem through open APIs, while continuing to advocate for trust, transparency and openness." -- Anil Jain, Vice President and Chief Health Informatics Officer, IBM Watson Health

"This cross-industry effort is tremendously important for the future of healthcare and technology," said Peter Lee, corporate vice president, Microsoft Healthcare. "Microsoft is heavily engaged and actively contributing through open source and open standards such as HL7 FHIR, and by building health data interoperability into the core of our cloud services. Our work is focused on bringing developers together to collaborate and more easily build data-rich health solutions that move the industry forward."

"Oracle is committed to supporting the healthcare industry in its quest to improve patient outcomes and care, and interoperability is essential to this mission," said Steve Rosenberg, vice president and general manager for Oracle Health Sciences. "As new developments in data management, such as artificial and machine learning proliferate, the ability to leverage extensive datasets could be the difference in solving some of the world's most pressing medical mysteries and speeding time to cure. No one organization can do this alone. As such, Oracle's healthcare technology platform adheres to industry-standards and was designed for interoperability enabling diverse data to be aggregated and leveraged by relevant parties. Today's announcement and the commitment from Oracle and other leading technology vendors is a step forward in eliminating the friction that exists in the healthcare system today."

"Salesforce is thrilled to join our tech peers in support of healthcare interoperability," said Ashwini Zenooz, MD, SVP & GM of Healthcare and Life Sciences at Salesforce. "As healthcare continues to embrace FHIR and API-based data sharing, we are eager to accelerate our customer's path toward delivering an exceptional patient and member experience, achieving operational efficiencies and driving higher quality outcomes."