A Conversation with Jake Lieman, VP of Engineering at Artifact Health

Artifact Health is proud to announce its mobile physician query platform is now available within the Cerner App Gallery, a marketplace for healthcare software products that integrate with Cerner using Cerner's Application Programming Interface (API). The Artifact/Cerner integration gives physicians mobile technology to ensure accuracy of patient records.

Jake Lieman Picture

Artifact recently completed Cerner Open Developer Experience (code) Program validation. We spoke with our own Jake Lieman, Vice President of Engineering at Artifact Health, regarding the code Program, the integration of Artifact's mobile physician query platform, and the benefits for Cerner hospitals.

What is the Cerner Open Developer Experience (code) Program?

The code Program is about furthering interoperability of patient information. But, it's not just about technology. The code Program also encourages developers to solve today's complex healthcare problems by providing them with a platform to build sophisticated, more reliable systems.

Healthcare providers and technology vendors have recognized traditional HL7 integrations to be slow, complicated and lacking in modern technologies. Over the years, we've all become efficient at building HL7 interfaces, but these integrations remain as one of the most expensive and complicated parts of the implementation process.

The code Program was designed to make it easy for technology vendors and health systems to integrate their own platforms with Cerner's data using modern technologies and a new interoperability standard called SMART on FHIR. The code Program is Cerner's implementation of the SMART on FHIR paradigm.

What is SMART on FHIR?

SMART on FHIR is the combination of two complementary standards. SMART stands for "Substitutable Medical Applications Reusable Technologies" (a name only a programmer could love!) and is a standard for launching third-party applications from EMRs. FHIR stands for "Fast Healthcare Interoperability Resources" and is a standard for electronic exchange of health information.

FHIR, in particular, is a real paradigm shift for healthcare IT. With traditional HL7 integration, every hospital system maintains a copy of the patient record. When a patient is admitted, transferred, receives a labs result, etc., the source system pushes a copy of this information to all other systems that need it. All receiving systems store a copy of the information in case needed in the future. This process is a terribly inefficient way to do things. It requires multiple systems to store significant amounts of patient information they may never need.

FHIR turns this model on its head. Instead of the source system pushing all data to receiving systems, a receiving system pulls only the data needed from the source system FHIR APIs. With this model, the receiving system is guaranteed to always have the most current information on a patient and only has information on the patients it needs, preferable from both a storage and security perspective.

How does a vendor's application get validated for use?

The Artifact application has undergone an exhaustive review to ensure it meets the security, functional, operational and usability standards set by Cerner. The Cerner validation and certification process attests that Artifact can be implemented safely, efficiently and reliably for Cerner clients.

We were able to update the Artifact platform for use inside of PowerChart in just a few months. One of the reasons for this quick implementation is we built Artifact from the ground up to support FHIR API integration. When we started building Artifact six years ago, FHIR was not yet even a draft standard. However, we recognized that FHIR was the future, so we structured our underlying infrastructure to support both tradition push-based HL7 integration and pull-based API integration, such as FHIR.

Why did Artifact Health decide to join the code Program?

Artifact is already deployed at many Cerner hospitals across the country. Providing an integration option directly supported by Cerner for future Cerner customers makes sense for a number of reasons, beginning with speed of implementation. When a hospital or health system signs a contract with Artifact, we want to help them get up and running as expeditiously as possible. We're always looking for ways to optimize the implementation process for our customers.

Secondly, the code Program allows us to achieve turn-key, plug and play integration with any Cerner hospital. This reduces overall integration time, and more importantly, reduces the hospital or health system's FTE resource time and costs by shifting integration responsibilities on to Artifact and Cerner.

Finally, as mentioned previously, using a pull-based API model for data integration with a hospital has many advantages, including reduced infrastructure and bandwidth requirements, reduced risk and increased security.

How will Artifact's inclusion in the code Program benefit Cerner clients?

Artifact's availability within the Cerner App Gallery introduces Cerner hospitals and health systems to a mobile clinical documentation improvement (CDI) solution that gives physicians an easier way to respond to requests for documentation clarification, ultimately adding greater specificity to the patient's record and giving providers back valuable time to focus on patient care.

Traditionally, the physician query process is onerous and time-consuming for physicians, clinical documentation specialists and medical coders. Cerner hospitals often resort to delivering queries to physicians through the Message Center, which is cluttered with many other messages and requires multiple steps for the physician to respond.

With Artifact's HIPAA-compliant, cloud-based, mobile query platform, physicians can respond to a query compliantly in seconds with as few as three taps on their smartphone. Engaging physicians with a faster, more simplified process drives improvements in hospital coding accuracy and publicly reported quality measures.

In addition to turn-key technical integration and reduction in IT resources, Cerner hospitals can have real-time access to Cerner data within Artifact. This gives physicians everything they need to respond to a query without having to go back to the chart.

Artifact is also seamlessly available inside PowerChart so physicians have multiple ways to access Artifact and respond to documentation clarification queries.

For more information

Contact Jake at jlieman@artifacthealth.com. View our code Program page here.