The last decade has seen an explosion in game-changing advances in delivering and managing health care. Many of these innovations have been made possible due to the breakthrough in the field of software sciences and computerized technologies.
Kanda has been working with established Digital Health vendors to enable their rapid delivery of creative products and solutions to healthcare providers. For eHealth software vendors specializing in mobile Health (mHealth), Healthcare Genomics and Bioinformatics, Clinical Reporting and Analytics with Big Data developing SaaS and cloud offerings present a variety of challenges: dealing with regulatory requirements (HIPAA,FDA, CLIA), supporting healthcare-specific interoperability protocol (HL7, FHIR)), integration with large-scale EHR platforms and handling large volumes of rich and complex clinical data.
While building our Digital Health Software Development practice, Kanda has trained a cadre of Business Analysts, Software Architects, Software Engineers and QA Professionals in the art and science of working with Genomic data, full stack of rich clinical data (ADT, Labs, Observations, Medication Orders, Billing), clinical and administrative workflows, EDI tools and protocols (HL7, Ansi X.12), clinical data warehousing (CDM), coding standards and nomenclatures (UB-04, ICD9-10, CPT-4, DSM-4, SNOMED, LOINC, NCD, RxNorm, DiagnosisRx), and radiology imaging (DICOM).
Deploying customer-facing solutions hosted in the Cloud environment, such as AWS, adds another layer of complexity to the regulatory-compliant engineering processes. In our engagements Kanda engineers have mastered working with Amazon Web Services EC2 commercial cloud security APIs and administrative controls, while making sure that the security and privacy of patient data at rest and in transmission is protected.
Our expertise in building secure Digital Health in the cloud environment – private, commercial and hybrid – helps Kanda’s customers rapidly deliver high quality, compliant solutions to numerous healthcare constituencies – acute care hospitals, rehabilitation centers, payers, medical practices, pharmacies, laboratories, doctors and patients.
Meaningful Use, Interoperability and Clinical Integration
The U.S. Government stimulus program, Meaningful Use, signed into law as part of American Recovery and Reinvestment Act of 2009 has become a driver for innovation in the Healthcare IT sector. Kanda has been working with medical health software vendors in two areas related to Meaningful use. We help design and rapidly implement features as they make Healthcare Information Technology solutions for the first two phases of Meaningful Use compliance available to the hospitals and providers. We also support software vendors in having their products certified for meaningful use regulations.
As the Meaningful Use program gained its maturity and entered into the third and potentially final phase, the issue of interoperability is becoming more important. A new set of standards are being published by the Interoperability Standards Advisory (ISA) in collaboration with the Office of the National Coordinator for Health Information Technology (ONC).
The issue of interoperability in private and government healthcare has become one of the chief concerns with the lawmakers, healthcare policy administrators and clinical community. Having the complete patient data from multiple sources such as provider office, ambulatory, hospital, rehabilitation and dialysis clinics available at the decision-making point is one of the critical success factors in improving the patient safety and achieving better outcomes. Enabled by IT interoperability, clinical integration is powered by clinical data, coding standards and protocols.
Kanda has been on the forefront of interoperability and integration protocols for the most of our twenty-year history.
Even prior to establishing our Digital Health practice, many if not most of our clients ranging from D&B to Nuance had been operating in a highly integrated multi-vendor environment rich with ETL, SOA and RESTFUL API integration. With that background, we are able to speed up our customers’ ability to develop products that utilize a full stack of rich clinical data, collected both automatically and manually including demographics, laboratory results, observations, imaging and billing. With that background, we are able to speed up our customers’ ability to develop products that utilize a full stack of rich clinical, automatically and manually collected patient-centric data, including demographics, laboratory results, observations, imaging and billing data.
Some of the coding standards we are experienced with include: ICD9/10, LOINC, CPT, SNOMED CT. Our interface developers have hand-on experience with HL7 v. 2.4, ANSI X12 and, most recently, FHIR®.
For many years patients with various conditions have been treated based on industry standard clinical guidelines and protocols. With an advent of personalized medicine, the fusion of genetic, genomic and clinical data has been put in service to improve the patient outcomes. Predicting the individual’s risk for developing certain conditions, course of a disease, and most importantly, aligning drug treatments with genetic biomarkers has been made possible as gene sequencing technologies such as NGS (next generation sequencing) have become more mature and widely available in the academic settings and molecular laboratories.
The subject of Personalized Medicine is of an interest to a variety of healthcare constituencies, including but not limited to Pharma research companies, acute care centers, community physicians, and payers. Physicians of various medical specialties, but most notably oncologists, specializing in treatment patients with solid tumors, have been actively using genetic and molecular testing capabilities. To illustrate this point: the recent studies suggest that more than half of patients with Non-Small Cell Lung Cancer are linked to at least 10 key biomarkers, hence enabling oncologists to use molecular profiling combined with evidence-based treatment information.
For software and bioinformatics solution vendors, developing workflow and analytical products presents a variety of challenges: dealing with data volumes and scientific complexity, data exchange and interoperability between different participating entities, regulatory compliance with HIPAA and CLIA.
Our clients are effectively utilizing the RESTful API-based functionality, which we have built for them in order to create interoperable solutions, serving the needs of clinical oncologists and molecular pathologists.
Mobility in Healthcare
Since the mid-90s with arrival of handheld devices with extended capabilities, first called “smartphones” by Ericcson, software developers have been looking for creative and efficient ways to use these devices in healthcare. Obvious use cases include extending the data viewing and entry capabilities of EHRs to a mobile device in the hands of a clinician. Performing a positive patient identification, checking laboratory results, ordering tests, charge capture and clinical notes – all seemed no brainer disruptive ideas. However, as the mHealth industry gained maturity and gained traction with vendors, hospitals and individual providers, it had become increasingly apparent that these great benefits also impose a variety of challenges on mobile developers: technical, regulatory, workflow usability and performance. The success stories of our mHealth clients attest to our expertise in this challenging domain.
With a variety of competing devices, manufacturers, and platforms (iOs, Android, Microsoft and Blackberry), all mHealth solution vendors face a difficult support decisions: building native applications for each platform vs a platform-independent framework.
Kanda mobile engineers have done both: developing native applications for iOS and Android, as well as building its own platform-agnostic frameworks, supporting daily clinical practice. Another important aspect is a great variability of manufacturer/carrier-specific versions of Android and associated with it Quality Assurance challenge. Our testing methodologies allow for expedient regression cycles and reduced time to market.
The successful mobile solutions used by physicians and nurses have to fit into the existing IT infrastructure of acute care hospitals, rehabilitation centers and outpatient clinics. In addition for the application security and compliance with all applicable regulations (HIPAA being the most common), the UX design is the key to successful adoption by clinicians. Kanda’s UX engineers have strong industry expertise with mobile clinical workflows, designing solutions that physicians, nurses and healthcare coordinators use in their day-to-day practice.
SaaS to hospitals and post-acute treatment centers.
Curaspan wished to modernize its current solution utilizing up-to-date technologies and software and retained Kanda services to assist with rapid development of the new product suite. Kanda Software built a new functional module for the suite, various system utilities as well as assisted with QA efforts, including test automation.
Kanda has provided custom-fit teams that solve crucial issues in Product Quality and Rapid Time to Market.We have done various types of testing of the product as well as cross-browser testing of the installer deployment.
Kanda has developed back-end architecture using PHP development framework as well as applied in depth knowledge of search algorithm implementation and web-based comparison applications to create simple, but sophisticated recommendation engine.