4 breakthrough movements of healthcare software development

The digitization of healthcare dates back to the 1960s when the first electronic health records (EHRs) were developed for digital recordkeeping. The EHR consolidates patient data, including health history, medical diagnoses, treatments, immunization records, allergies, and test results, under one application, and allows authorized users to view, manage, and share patient data across healthcare organizations.

Digital health software development improved in the 1990s, and patient portals emerged from the EHR, with MyChart at the Palo Alto Medical Foundation and Indivo at Boston Children’s Hospital, as part of the movement to increase patients’ engagement in their own health. This trend picked up speed in the 2000s and 2010s as Obama-era legislation mandated the use of EHRs across all care delivery settings, and the booming consumer technology trend shifted patient expectations.

Though early healthcare digitization improved the process of collecting and storing patient health information, it did not fully revolutionize access to care. This left the challenge of health disparities in rural residents compared to their urban counterparts. These geographic disparities are well-documented, including higher likelihoods of dying from heart disease, cancer, unintentional injury, and stroke. Among the nuanced reasons that factor into these differential health outcomes is poorer access to healthcare, which includes longer commute times to specialty or emergency care and being less likely to have health insurance. In response, medical software projects to meet this newfound need for virtual care facilitated the improvement in the field of tele software development.

As the COVID-19 pandemic unfolded, people and resources were redistributed across the system to assist with COVID-related tasks, such as diagnosing and treating patients. Average wait times for an appointment increased to 26 days in 2022, compared to 24.1 days in 2017. However, the rapid embrace of telehealth and virtual-first care during the pandemic led to substantial legal and infrastructure progress. These monumental shifts have allowed for more complete virtual-first care delivery for low acuity health needs, and have also expanded access across geographic boundaries. The most prominent examples include virtual mental healthcare, direct-to-consumer specialty care and prescriptions, and condition management technology for aging Americans.

The accelerated adoption of telehealth became a key player in mitigating the reduced access to healthcare during the pandemic. Telehealth is a convenient option; it cuts down transportation and wait times and is often a more readily available medium through which to connect with a healthcare provider, with opportunities for expanding access geographically.

Digital health care is particularly relevant for patients that live in rural locations or areas with limited access to healthcare facilities. Patients benefit from increased convenience, timely access to care, and expanded reach. This virtual touchpoint, which was previously unavailable, has since become widely adopted and preferred among patients for certain situations. Direct-to-consumer telehealth platforms that connect patients to doctors in mere minutes also reduce the multi-week wait time for in-person visits. Innovation in the sector overall is driving an uptick in the number and variety of health tech companies that are reimagining healthcare software developments to meet patient needs and expectations.

Of course, telehealth can’t replace in-person care for all instances. High acuity care, emergency care, and routine exams and labs are difficult to replicate virtually. But with consumer expectations at an all-time high, the industry is looking toward other ways to improve efficiency and experience including home diagnostics, virtual patient intake and triage ahead of appointments, and more continuous engagement, education, and symptom tracking through mobile and web experiences.

The digital transformation of healthcare has made patient engagement and empowerment more relevant and accessible by setting the foundation for trends toward personalized, patient-centric care. Along with the rise of healthcare consumerism, this means that patients are taking greater control of their healthcare decisions. Here are a few examples of how technology and patient engagement are linked:

• EHRs and patient portals grant greater access to patient health data for patients and providers alike. Through the patient portal, patients can communicate with their provider, see their test results, make new appointments, and more easily engage in their health decisions.
• Omnichannel healthcare encourages engagement and improves the patient experience by creating a seamless journey across all virtual and in-person touchpoints that could otherwise, in isolation, be overwhelming for patients to make effective use of, thus enhancing digital patient engagement.
• Care navigation tools, many of which operate through digital platforms, help patients find solutions and achieve their health goals by increasing patient knowledge and understanding of the healthcare system. Equipped with knowledge, advocates, and/or assistants, patients become more well-positioned to actively engage with making informed decisions about their care. This includes clinical, financial, and administrative aspects.
• Wearable medical devices, such as continuous glucose monitoring devices and fitness trackers, enable immediate and constant observation of patient vitals and activity. When something is wrong, the wearer is notified and can proactively follow-up with their healthcare provider.

These digital patient engagement and empowerment technologies are changing the way healthcare is experienced by shifting encounters from discrete, measurable visits at doctor’s appointments to continuous involvement through opportunities to engage in care outside of the traditional hospital setting. This is particularly impactful for patients managing one or many chronic conditions that involve continuous, complex management and care navigation. Healthcare UX/UI design plays an integral role in enhancing patient engagement and empowerment. Healthcare software developers plan the digital experience for patients, and effective UX/UI design plays a major role in user retention for healthcare apps.

The digital nature of these patient engagement and empowerment tools also make them a valuable source of healthcare data that can be fed into data analytics tools to generate actionable insights.

By analyzing large datasets, healthcare software solutions can identify patterns, trends, and correlations that help in population health management, disease surveillance, and resource allocation. Comprehensive patient data can be aggregated to study how symptoms present and progress in different groups of people, or how different populations respond to a medication or treatment. This data-driven approach enables healthcare organizations to make informed decisions and improve the quality and efficiency of care delivery. For example, personalized medicine, remote patient monitoring, and wearable devices leverage these healthcare analytics to optimize individual patient care. Regardless of the healthcare sector, developing medical software requires a robust data strategy.

Data management is the underlying thread that pins these pieces together. It includes the organization, storage, protection, and analysis of health data. Data from disparate sources, including EHRs, public health repositories, and clinical trials are used, and consequently, are reported in many different formats. This raises the challenge of interoperability, the topic of the next section. It is ubiquitous in healthcare, given that the system in the US is so fragmented.

Healthcare interoperability refers to the ability for different systems to exchange and use health information. Since the patient experience may involve multiple providers, hospitals, and health plans, healthcare interoperability allows for more seamless patient data flow among these entities, reducing friction and boosting efficiency.

When EHRs were popularized, the sheer number of certified EHR systems that were implemented but not interoperable resulted in disparate systems that lacked the functionality of seamless data flow from one system to another. Even EHR systems built on the same platform can lack interoperability, since custom healthcare software for the EHR can be implemented by each hospital.

When there is a lack of healthcare data interoperability, providers may get an incomplete picture of the patient. As mentioned above, EHRs are a crucial piece in helping providers have a comprehensive view of a patient’s care, including medical history and allergies. If a patient is admitted to an emergency room at a hospital that uses a different EHR system than their preferred hospital, the lack of interoperability could potentially escalate the situation into a life-threatening one if there isn’t a swift process to retrieve the patient’s data.

Efforts to improve health IT interoperability include implementing standards such as HL7 (Health Level 7), and more recently, FHIR (Fast Healthcare Interoperability Resources).

FHIR builds on HL7, an international set of standards for exchanging information between EHRs, and includes capabilities to support web services and open web technologies. FHIR by itself is not enough to implement interoperability; FHIR provides an API (application programming interface) for separate applications to communicate with each other, but there still needs to be a way for third-party applications to launch the EHR. This is effectively where SMART (Substitutable Medical Applications and Reusable Technologies) comes in. SMART provides a standard for how apps can be integrated and interoperable across the health care system. The SMART on FHIR protocol allows for externally hosted third-party applications to be embedded and launched from directly within the EHR instance for ease of use.

Learn more about SMART on FHIR in HTD’s deep-dive whitepaper.

Another piece of interoperability in healthcare is health information exchange (HIE). EHRs by themselves are isolated troves of patient data, and HIEs connect the EHR systems to allow health care providers to securely access and share patient data. Healthcare data interoperability is crucial to ensuring timely and smooth patient care.

The principles of healthcare interoperability and integration can be achieved through SMART app marketplaces, in which all the healthcare software applications are supported by SMART on FHIR, such as the app gallery hosted by SMART Health IT. The SMART on FHIR protocol enables integration and interoperability across different platforms, which can simplify and streamline clinical workflows for healthcare practitioners.

Progress in healthcare software solutions has been accentuated by formative trends in four areas. The digitization of healthcare has improved access and uptake of medical software services.

Looking forward at emerging trends that are likely to shape the healthcare software industry, there’s no doubt that artificial intelligence will be utilized more rapidly and prominently in healthcare. It has taken the world by storm, and healthcare software companies are swiftly exploring the field. To name a few, Mayo Clinic and Google Cloud are partnering to enhance search capabilities with generative AI, GenHealth created a medical parallel to ChatGPT that uses medical events instead of language data, and Epic is partnering with Microsoft to utilize generative AI into EHRs. At the forefront of these developments are much-needed discussions on the role of the FDA in regulating AI in healthcare.

The ever-evolving landscape of software development services for healthcare also paves opportunities for novel ideas, design, and execution. HTD works in the digital healthcare ecosystem to plan, design, and build care delivery software systems. Get in touch with us at info@htdhealth.com for a free consultation.