Healthcare Integration and Interoperability with Mirth Connect and AWS

By Saurabh Mishra, Sr. Partner Solutions Architect – AWS
By Padma Iyer, Sr. Customer Solutions Manager – AWS
By Muhammad Chebli, VP Solutions – NextGen Healthcare

NextGen Healthcare

The digital transformation of healthcare requires that organizations securely and efficiently exchange health information. An efficient data exchange mechanism not only facilitates seamless interoperability among these systems but also forms the foundation for advanced analytics, real-time decision-making, and improved patient care and access.

In the United States, healthcare data sharing is subject to regulations such as HIPAA, the 21st Century Cures Act, and the HHS’s latest HT-1 rule. Canada, the European Union, and other jurisdictions have their own versions of privacy and data exchange rules. These regulations require health delivery organizations to navigate the complex terrain of integrating disparate systems, ensuring data integrity, and complying with evolving regulatory standards.

In the past, most exchange patterns focused on exchanging data between disparate Electronic Health Record (EHR) applications. Recent trends in the health tech have expanded the surface area of required connectivity. This includes mobile apps, external clinical decision support (CDS) tools, population health analytics, and emerging Artificial Intelligent (AI) solutions.

How can organizations best achieve their interoperability goals?

With a variety of interoperability standards and exchange protocols like Health Level 7 Fast Healthcare Interoperability Resources (HL7 FHIR), Clinical Document Architecture (CDA), and IHE profiles it can be a challenge for organizations to develop and retain the talent and technical wherewithal to support these expanding capabilities.

Since 2006, organizations in more than 40 countries have used Mirth® Connect by NextGen Healthcare to solve interoperability use cases such as clinical message generation, transformation, routing, and delivery. NextGen Healthcare provides customized solutions to fit the needs of ambulatory practices. Their solutions empower patients to take control of their health and enable clinicians to be more productive and engaged. Mirth Connect, their solution for healthcare interoperability, enables seamless data exchange between various healthcare systems, promoting better care coordination.

Open-source solutions have emerged as pivotal tools in achieving healthcare interoperability. Mirth Connect stands out as a robust open-source integration engine that facilitates seamless data exchange across diverse healthcare platforms by leveraging standards like HL7 and FHIR. The inherent flexibility and community-driven enhancements of open-source tools offer healthcare organizations an adaptable and cost-effective approach to navigate the complex landscape of clinical data exchange. Mirth Connect offers flexible data handling, visual channel building, powerful data transformation, extensive connectors, real-time monitoring, robust security, and scalability. It supports standard formats – HL7, FHIR, DICOM, JSON and XML – and allows customization without coding, ensuring efficient healthcare system integration and data privacy.

Leverage Cloud Infrastructure with AWS

Mirth Connect on AWS provides additional benefits to healthcare organizations through scalable infrastructure, enhanced security, advanced analytics, faster innovation, cost optimization, and more. AWS offers over 200 fully featured services which can be used to form the backbone of a robust interoperability solution. This AWS white paper outlines how you can architect applications for HIPAA compliance and security rules to protect Protected Health Information (PHI). AWS Auto Scaling monitors your applications and automatically adjusts capacity to maintain optimal performance and remove the guess work from infrastructure provisioning. This blog discusses how to build a healthcare data hub with AWS and Mirth Connect.

Mirth® Cloud Connect: The Power of Managed Integration on AWS

For organizations that might find in-house integration a challenge, Mirth® Cloud Connect, a managed service by NextGen Healthcare, offers a viable solution by providing end-to-end integration. Mirth® Cloud Connect is available as a fully managed service on AWS. With 24x7x365 support, it supports interfaces built and managed on your behalf with cloud auto-scaling with disaster recovery.

Enabling Better Care with Mirth Connect and AWS

Healthcare organizations continuously generate large amounts of structured and unstructured health data from multiple systems, applications, and devices. The secure exchange and use of this data using FHIR standard can lead to better clinical decisions and improved operational efficiency. NextGen Mirth Connect and AWS Services can be integrated to build a solution to enable secure exchange of clinical data and visualize this data to help with better clinical decisions.

Figure 1 – Mirth Connect integrates with EHR and AWS services for better care decisions

EHR systems using Mirth Connect can transmit HL7 messages over HTTPS and directly invoke an API on Amazon API Gateway which invokes AWS Lambda function that persists HL7 messages in an Amazon S3 bucket. At this point, you can use Mirth Connect’s HL7 to FHIR converter, available with a Gold license, before storing the data in AWS HealthLake. HealthLake is a HIPAA-eligible service to securely store and transform healthcare data in a consistent and queryable FHIR R4 datastore that can be queried using Amazon Athena. HealthLake natively integrates with Athena, allowing you to write SQL queries on the FHIR data.

You can use this data to create dashboards and visualizations using Amazon QuickSight. With the ability to query patient data and visually interact with it, healthcare providers can look at health trends of a patient cohort or drill down to access 360⁰ view of a single patient’s health. These insights can help providers to make better care decisions. Data from Athena can be used to fine tune a machine learning model using Amazon SageMaker for predictive analytics, or it can be exposed to third-party downstream healthcare apps for further consumption. Additionally, providers can conversationally interact with this data with a generative AI application built using Amazon Bedrock. This blog discusses a solution to conversationally interact with healthcare data stored in HealthLake.

Conclusion

NextGen Healthcare’s Mirth Connect can be seamlessly integrated with AWS services to build a solution to securely transmit healthcare data, transform it to the standard FHIR format and store it securely in AWS HealthLake. This solution enables providers to leverage the power of AI, machine learning, and advanced analytics to make more informed decisions, ultimately leading to improved patient outcomes.

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