Expediting Healthcare Interoperability with Redox and AWS

By Nijay Patel, Product Strategy – Redox
By Brian Warwick, Sr. Partner Solutions Architect – AWS Healthcare and Life Sciences

Interoperability is one of the biggest challenges the healthcare industry faces today as organizations look to harness their business and clinical data to reimagine the healthcare experience, gain new insights, and improve care.

In order to accomplish these goals, healthcare organizations need to address interoperability so they can use the latest technology to assess, treat, monitor, and engage their patient populations.

For customers in the United States, interoperability has been accelerated by the 21st Century Cures Act, which requires that patients have access to Electronic Health Record (EHR) information in their medical records beginning April 5, 2021.

Healthcare organizations are naturally complex, with multitudes of solutions used for care and each solution potentially storing and exchanging data differently.

Additionally, while most health systems have one EHR in place, others who have undergone mergers may have several EHR solutions. All of this contributes to the challenge of achieving healthcare interoperability.

Developer teams can integrate with each of these systems on their own, but some teams expedite interoperability using third-party organizations to do the integration for them.

This post shows how Redox, an AWS Partner and EHR integration platform, accelerates healthcare interoperability for customers.

How Redox Works

Redox connects software applications to healthcare providers and healthcare interoperability networks. The product is backed by a team of healthcare interoperability specialists who do the heavy lifting of building connections to all EHRs in the market today.

Think of Redox as an API layer with an integration engine. It can read or write to any HL7v2 message, FHIR endpoint, CCDA Document, CSV, or other document formats, translate it to JSON, and expose that interaction as a single API. This allows applications to connect to any variety of systems, in any quantity, using only the Redox API.

For example, reading and writing notes from an EHR is different depending on the EHR used. Instead of having to figure out how to connect to an EHR, what format and API calls to use, what type of security and connections should be made, Redox allows you to develop against its API and Redox takes care of the rest.

The product has read and write capabilities into any EHR used around the world. To date, Redox has connected with more than 85 EHRs and 1,200 healthcare organizations.

The below diagram shows how this translation occurs at a high-level.

Figure 1 – Redox healthcare data normalization.

Accelerating Healthcare Application Development

Redox uses a standardized JSON format to create the Redox API, which enables third-party applications to read and write data with any EHR system via a single HTTPS connection.

Redox handles all of the data mapping, translation, and connectivity to the health system, ensuring the developer experience remains consistent across all health system sites. This allows application developers to focus on innovation, while Redox handles the connectivity between those solutions and their connected healthcare organizations.

Redox connects to a variety of critical health data sources, including claims, devices, admin, referrals, patient, provider, and scheduling. Visit the Redox documentation to read more about the options available.

To illustrate how simple Redox and Amazon Web Services (AWS) make EHR connectivity, let’s walk through the common use of adding a new clinical note to a patient’s chart.

By using Redox, you don’t have to worry about what EHR is being used and how to connect to it. Instead, simply send the note contents to the central Redox API and Redox takes care of the rest.

Setup

To get started, grab your Redox API key and API Secret from the Redox. If you don’t have one yet, you can sign up for a free Redox account and a set of developer credentials will be provisioned immediately.

Figure 2 – Redox API credentials are provisioned with your Redox account.

To help developers get started quickly, Redox provides a connection to its sandbox environment representing an EHR, along with a Postman collection that includes a series of example workflows.

Next, you can set up an AWS Lambda function to use the new Redox API credentials. Create a new Lambda function with the Node.js sample code below:

const https = require('https'); 

const defaultOptions = {
    host: 'api.redoxengine.com',
    headers: { 'Content-Type': 'application/json' },
    method: 'POST'
}

const post = (path, payload, authorization) => new Promise((resolve, reject) => {
    const options = { ...defaultOptions, path };
    if (authorization) {
        options.headers = { ...options.headers, authorization };
    }

    const req = https.request(options, res => {
        let buffer = "";
        res.on('data', chunk => buffer += chunk);
        res.on('end', () => resolve(JSON.parse(buffer)));
    });
    req.on('error', e => reject(e.message));
    req.write(JSON.stringify(payload));
    req.end();
})

exports.handler = async (event, context) => {
    const auth = await post("/auth/authenticate", { apiKey: process.env.REDOX_API_KEY, secret: process.env.REDOX_API_SECRET }, { 'Content-Type': 'application/json' });
    return await post("/endpoint", event.Message, 'Bearer ' + auth.accessToken);
}

You’ll need to configure two environment variables in your Lambda function to reference your Redox API credentials.

Figure 3 – Lambda Environment Variable setup.

Test Your Connection

Now, you should be all set to try out your new integration to Redox. You can configure a new Lambda test that will publish a message to the Redox Sandbox EHR.

In this case, we’ll send a simple plain text Clinical Note to Redox, but it’s common to send a document previously stored on Amazon Simple Storage Service (Amazon S3) using the base64 encoded payload option of the Redox API.

{
    "Message": {
        "Meta": {
            "DataModel": "Notes",
            "EventType": "New",
            "Destinations": [
                {
                    "ID": "af394f14-b34a-464f-8d24-895f370af4c9",
                    "Name": "Redox EMR"
                }
            ]
        },
        "Patient": {
            "Identifiers": [
                {
                    "ID": "000000001",
                    "IDType": "MR"
                }
            ]
        },
        "Note": {
            "ContentType": "Plain Text",
            "DocumentType": "Nurse Note",
            "DocumentID": "00000",
            "FileContents": "This is my sample note text. 
            "Provider": {
                "ID": "4356789876",
                "IDType": "NPI"
            },
            "Availability": "Available"
        }
    }
}

Once you have sent the new Patient Note request, you can view it in the Redox admin console and confirm the Redox platform received the contents successfully.

Figure 4 – View all your transactions in Redox.

In addition to seeing your request from Lambda to Redox, you can view the contents of your message as it’s sent to the health system, and the EHR’s response.

From here, you can use your single Redox API connection to integrate with thousands of health systems across the country no matter which EHR systems they are using.

Customer Story

“Every state has its own unique, mandatory reporting requirements for COVID-19 testing,” says Isaac Turner, CIO at Curative, which provides on-the-go testing, vaccinations, and other essential health services. “This can be challenging for an organization like ours, which is so focused on working as quickly as possible to scale up testing services nationwide.

“Redox has given us a secure and scalable integration strategy to quickly automate this reporting requirement across all the different systems we need to work with.” adds Turner. “Redox allows us to be confident this critical data will get to the right destination, in the proper format, and in a timely manner, so we can continue to focus on scaling out COVID-19 testing across the nation.”

As testing volume spiked, Redox’s use of Amazon RDS for PostgreSQL, Amazon S3, and Amazon Elastic Compute Cloud (Amazon EC2) allowed integrations to scale seamlessly without disruption to patient care.

Conclusion

Reading and writing information to Electronic Health Records (EHRs) does not have to be complicated. As demonstrated in this post, we were able to quickly build a solution that sends a note to an EHR using Redox and AWS.

By leveraging AWS and Redox, customers can focus on innovation and enable a quicker time to market. To learn more about enabling Redox for your organization, visit AWS Marketplace.

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Redox – AWS Partner Spotlight

Redox is an AWS Partner and EHR integration platform for digital health solutions that empowers healthcare applications to read, write, and query clinical data.

Contact Redox | Partner Overview | AWS Marketplace

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