Flexible Composable Health IT Platforms for Emergency Response

Abstract

Introduction:Health information technology, especially electronic health records (EHRs) pose difficult design problems due to the data and workflow complexity, high-stakes stressful nature of healthcare work, variability of information and collaboration needs and stakeholders. Emergency response poses further requirements. We propose a different, novel approach in which flexible ‘building block’ platforms composable by nonprogrammers could address rapid implementation and sharing of new functionality as needed at the point of care. In order to truly meet unpredicted emergency needs a philosophy of maximal flexibility and data comprehensiveness is required.Method:Existing technologies were used in new ways to permit prototype design of composable health IT platforms, intended to be added to existing health information systems, allowing nonprogrammers (including clinician end users) to assemble any desired data, visualization, and new logic to permit rapid tool deployment in emergencies. An example is the rapid composition of Covid-19 screening and treatment tools (in minutes) for fast implementation of new screening and care guidelines (as happens in a new epidemic), with usable visualization and decision tools.Results:Prototype systems were successfully built and configured for rapid tool creation for pandemic-specific needs including setup of automated screening and decision tools using EHR data plus point of care data gathering. These will be demonstrated. A modular, composable approach is usable by nonprogrammer clinicians, permitting those most familiar with rapidly changing clinical needs and guidelines to implement new health IT functionality directly instead of incurring delays typical when IT staff must do ad hoc programming. At this time new initiatives and mandates for health IT interoperability make this more easily doable than previously.Conclusion:Disaster response may be facilitated by a different approach to health IT design and use, with advantages for rapid response, streamlining clinician work, and ease of use.