Anmol Satija – Hi guys, welcome to the unthinkable tech podcast, the go to source for the pulse and technology shaping our future. I am Anmol Satija and today we are talking about something that stands at the very heart of healthcare transformation. That is interoperability. And it’s kind of a big word, but at its core, it’s about making healthcare data work seamlessly across systems, providers and most importantly for the patients.

So think about it. When was the last time you had to fill out the same medical history form at different clinics or struggle to get your health records from one hospital to another? So these everyday frustrations aren’t just inconveniences, they are real consequences for patient care, cost and accessibility. And to break this down and explore how we can create a more connected, patient-centric healthcare ecosystem.

I am thrilled to welcome Debra Griffin with us today. Debra is a total powerhouse. She has spent over 40 years working to improve rural healthcare access, leading hospitals and pioneering patient-centered interoperability solutions. She even testified before a SANEIT subcommittee advocating for better funding for critical access hospitals.

And she’s also the co-founder of ppxTEC, a company building patient-centered health data solutions. I am thrilled to have her with us today. So let’s get started. Hi, Debra. How are you doing? Glad to have you here.

Debra Griffin – Anmol, thank you for inviting me and I’m so grateful for that kind introduction.

What is interoperability in Healthcare?

Anmol Satija – The pleasure is on mine, Debra. So Debra, know, interoperability is one of those words that gets thrown around a lot in healthcare discussions. And like I said, it is about making healthcare system talk to each other seamlessly. But in reality, the landscape is still fragmented, right? Patients struggle to access their own records. Hospital use different systems that don’t communicate well and critical health data often gets lost in silos. So to get going with our conversation, so I would like to start with defining interoperability in healthcare and what impact does it have on the overall healthcare ecosystem.

Debra Griffin – Well, interoperability simply is computer software devices and applications connecting with other entities for the benefit of the patients sharing in their holistic health histories without them having to extend any efforts. So it’s across one system to another system and it has to be seamless, as you said.

It should be in real time and it should be bi-directional. It goes both ways from the patient caregiver to the provider, whatever type that is, and from the provider type to the patient caregiver.

Anmol Satija – Right. Okay. So how do you think it benefits the overall healthcare space? Like why is it important?

The benefits of interoperability for patients and providers

Debra Griffin – The importance has to do twofold, one from a human standpoint. Healthcare is wealth and knowledge is health. Then, avocation of that knowledge is health. And I strongly believe that empowering consumers of the patient with that data so that they can be an active participant in their healthcare treatment or that healthcare ecosystem.

So if you have that information, you understand where you are in that journey. But because of the fragmentation in the silos, as you mentioned, there are various provider types. There’s various types of healthcare data, mental health, social, economic determinations of health. And if your data is trapped in one doctor’s silo, they don’t have the benefit when you visit them what the other doctors have done or is doing for you.

So it helps the patient, number one, but it also helps the healthcare ecosystem because interoperability improves patient outcomes because they get to participate and advocate for themselves.

But it also helps the patient brings information like text or images where the doctors, when you present for a treatment, the doctor don’t have to repeat redundant procedures or images because they have, the patients are presenting what they’ve had in the past. I’m not advocating standard of care. I don’t know what that limit is, but they can look back for a foundation or a reference of what was done in the past so that they, won’t have to guess the whole treatment protocol or diagnosis or help to get to a diagnosis quicker. And then healthcare costs is tremendous and staggering in most spaces. And interoperability done in a way where it’s joint sharing, I think, takes the burden off of the physician and the system to come up with the right answer every time.

But it also helps the patient to get a better diagnosis or opinion from the doctor because he has various informations to pull from. But the information has to be concise and pertinent to that doctor and that visit because their time limit is precious.

Why seamless data exchange is still a struggle?

Anmol Satija – Yeah. Right, Debra, yeah, and when you lay it like that, it makes so much sense. But here’s the thing, if the benefits are so obvious, why is this still such a struggle? We have got the technology and we know what needs to be done. Yet seamless data exchange still feels like an uphill battle. So what is holding us back?

Debra Griffin – Well, honestly, I say the real barrier is a will, W-I-L-L.

The will is because business models, most some of them are proprietary, it’s slow to want to share that data with patients. One is because most providers in most systems and in most countries look at that data as their asset. And you know, who wants to quickly share their asset?

And then a lot of providers understand and some don’t what true interoperability might do to their business model in the future because it’s currently functioning where they’re okay with it. And here in America, we have a hybrid healthcare system, public and private. The public spends a lot of money in funded, but the private is a formidable part of the system. And I think the…

The public is trying to get the private to agree that this needs to be done. The technology is there, the benefits is there, the will has to be there. So in America, in 2020, the 21st Century Cures Act became a law and you still have hesitation, fragmentations and silos.

But also in Europe and other countries like India. It is not as much a hybrid system, but you still have to have that wheel because it is not technology. It is not the benefit of what it will do. But I am certain with the revolution of AI and it’s pushing interoperability forward because AI is built, its foundation is data, not only good data, but broad data and broad content. And I think that that will foster interoperability in a way that it needs to be earlier. What earlier might be, I can’t say, but I think it’s interesting to know that AI became available to the public in the fifties.

Uh, yeah. So it’s been around, we say the AI revolution, uh, but it’s evolving. and, and in 2023, uh, when open AI, you know, came to the forefront, everybody started, um, trying to adapt and get on the AI wagon or the AI train. But we all know that AI has been around for a while.

Because even before 2023 with these smart devices that we have, we’ve got track tracking in that format. But also, maybe in the, in the, in the nineties to the early two thousands, you had the Roomba, the little robots that would follow you back. They had some forms of AI in, in it.

So everybody is looking at AI in terms of harnessing all of this data that comes about in these different things to make sense of it, to make it actionable for forecasting, for analyzing, and then maybe optimizing it into something that’s usable for not only the providers, but the consumers.

Anmol Satija – Definitely and I would agree to the point that you said that data is the foundation of AI and we’ll definitely touch upon this topic as well as it is the hot topic and the most discussed one and also the crucial one to discuss the fact of AI and what opportunity does it hold for interoperability and healthcare space itself. But before jumping on to that, I would like to say that whatever you said about the wheel that you just mentioned, it totally tracks down.

Anmol Satija – And it also, it’s not just about getting different systems to talk. It is also about making sure that they’re speaking the same language. They’re able to handle massive amount of data and dealing with all the complexities of patient records, insurance, provider networks. And of course, the one main thing that you mentioned about the private and the, you know, the battle between the private sector and the public sector within the healthcare eco space.

The role of regulations in driving healthcare interoperability

So no wonder it’s a challenge to maintain interoperability. But I also imagine that policies and regulations also play a huge role in either pushing things forward or slowing them down. So how do government policies and health care regulations impact interoperability progress?

Debra Griffin – Well, regulations is a formidable driver. And that was my mentioning of the 21st Century Cures Act in America, because it’s a law. And if you would think that it’s a law, that it would just, you know, fold out and unfold and happen. And also part of that law is forbidding information blocking of large silo systems or legacy systems.

So that’s the barrier. But the other one is standardization of how that data is to be passed. Most of it passed, had to travel. Most of it is passed on FHIR protocols. That’s the highway or HL7 standards, which is the highway. But the regulatory issues, I don’t think personally is the biggest hindrance.

I think people use privacy and security as a hindrance, just as a rouge. Yes, privacy and security is very important. I don’t want to minimize that. even in this cyber, right, even in this cybersecurity space, it’s very, very important. But when you’re talking about interoperability in a patient-centric mode, that information is going to the patient. And there should not be any privacy issue.

And then people say, well, when that data is traveling on those protocols, fire HL, HL seven protocols, then that data that’s traveling in transit is encrypted. And when it gets in rest, it should be not encrypted so that the patient themselves can see it in a way that they can understand it. You know, sometimes we get files and they zip them and that, know, it’s a part of encrypting it.

So that if it falls out or some kind of way, whoever gets it don’t have access to the zip. But once you get it, they’ll give you a password or something to unzip that file. So I really think it goes back to WIll, W-I-L-L, and that data in the past has been an asset. I think too much focus has been on the data.

Here in America in electronic health records, if you do your research, only about 30 % of the population has a hospital encounter. So you got 70 % of the data that’s out there that they could refocus it. And I think if we refocus it where the patient is demanding interoperability and access to all of their data to share, then that would force entities to say, okay,

This is a demand that the patients want. We’ve got to figure out how to unleash this, but also protect our business models or find new strategies in sharing the patient’s data with them or their caregivers. Because lack of information is a great stumbling block. I’d like to give you a quick example.

In 1989, I was diagnosed with breast cancer. And that was 37 years ago. The technology is nowhere near where it was now. I had to navigate my health journey, my treatment journey through this ecosystem alone. I was not an expert. I was a 30-year-old single woman trying to decide how I would get through this past and my basic concern was to live, L-I-V-E. I wanted to live, I didn’t want to die. And so I had to become my own advocate.

There was no internet at that time. So we didn’t have the internet, we didn’t have chat GBT, we didn’t have DC, we didn’t have none of that. I had to become my advocate on tumor type and care processes going forward.

And I was blessed enough in that space to be an administrator of a rural hospital. I got my biopsy done at that facility and my tumor biopsy went to a pathologist that I contracted with with my hospital. So he called me and he gave me my report, but he also gave me an hour’s worth of learning about my tumor type, treatment type, treatment protocols, what he thought I should do, just out of the kindness of his heart. And that was my basis and foundation of saying, okay, I’ve got to be as much a part of this than the oncologist. The oncologist has a part to play, but I have a part to play. If I don’t advocate for myself and their decisions that are made that come back and hinder my coming through this in a successful way, oncologist will be sad, but then I’m going to be sick and dying.

And I was very vocal in that space. So advocacy cannot happen if you don’t have information. advocacy is important because I think if anybody did their research, patients who advocate for themselves or their family members in these dire spaces, and it doesn’t have to be a cancer diagnosis.

It can be any kind of treatment through the plan, through the healthcare ecosystem. They come out better. They’re better outcomes. That’s proven research because the doctor has so much on them already. They have other pressures from life, other pressures from their profession, other pressures from payment and policy, from a policy basis. And, you know, so they’re giving you the best that they have.

And then they have pressures from the liability standpoint of they’ve invested so much in themselves and in their skill and they want to make a good decision and they’re using maybe clinical standards to gauge treatment plans. And that might work for some people, but not for others. And who better know how you feel and how you respond to something other than yourself. And you’re not trying to play the doctor.

In that role, you’re just giving them the benefit of what you feel, how you feel, and how you would like to be a part of this and in the decision making process. Data is needed and advocacy is needed.

Anmol Satija – Definitely, Debra. I think the story that you shared just now is very enlightening and very empowering. And it is great that you were not just about to overcome your disease, but you have learned so much through it. And you are learning and building on to that thought of advocacy. Definitely a good thought and a thing that everybody should learn from.

And I also love the point about patient being the driving force behind their treatment and behind demanding that they need to get the information. They need to know about their treatment plans. They need to know what is happening and how they can contribute towards their treatment itself. So that is also a great point. And moving on, so from here, I would really like to, you know, touch upon the emerging solutions like you just talked about AI.

AI and Generative AI in healthcare

So it is one of the biggest trends right now and we see it revolutionizing industries and healthcare is no exception. So from your perspective, what is the value of AI or Gen. AI to say that it creates in healthcare?

Debra Griffin – I want to read this one statement before I get into GEN.ai. IBM reports that healthcare data is estimated to double every 73 days by 2025. There is a conglomerate of different types of data, data sets, and data also depreciates because if it’s not dealt with timely, it means nothing.

And when we’re talking about generatively AI, we’re talking about a way to harness that data in the healthcare field, forecasting that data, analyzing that data, and trying to use that data to make it actionable in a clinical standpoint. Most people refer that to what it makes can do for the clinical record and help the doctor in also supporting them and capturing information on a visit, but also taking that information and putting it into a clinical note or the chart in a way where it can be excised in a way that when needed, it can be looked at in a more succinct manner is evolving, because AI, whether it’s generative or not, it’s all built on foundational data, but large language models.

And there has to be, what I call practice in these large language models. have to have, be able to bring in all of this data, harness that data, and then try to analyze that data, so that it can have a reference for research and use cases.

So if they put my information in there, it’s got other things to pull from because it needs context to help build the use cases, to help with the research or help bring the volume of data out there so that it can be useful for that visit or what they’re trying to do.

Anmol Satija – Right. Okay. So definitely, I think it is also, you know, tackling some of the biggest bottlenecks in data sharing and standardization. So if we reduce the manual workload and make interoperability more seamless, that would be a huge win for both providers and the patients. But as we have discussed few of the challenges earlier in the conversation as well, AI is also not without any its own challenges.

Challenges with AI: Bias, privacy, and reliability in healthcare

So with all this powerful technologies come concerns around data privacy, potential biases in AI models and reliability of AI driven decisions. know, healthcare is a critical space to be in and relying on AI driven decisions or to say, you know, the information that it’s sharing.

How do you see as is it a huddle, a dilemma that needs to be treated? What do you feel about it? How can we use it effectively and efficiently?

Debra Griffin – I think AI is 100 % needed in health care. I think that they should take the guards off and see what it can produce. I see AI as an enhancement to everything that’s done when we talk in health care. I always think that there will need to be human involvement because we’re talking about health care.

It enhances to providers with their information and how that information is analyzed and conglomerate and complex information. think AI could also help the patients get their data summarized. And if they’re going out to various specialties, when they go out to a cardiologist and the cardiologist maybe sent them to other types of doctors, that it would help it pull out that information that’s pertinent in that patient’s. Smart device and record pull out what’s pertinent for the cardiology for interest of time and help to make a quick diagnosis. you know, people are saying what role does individual and AI, if you’re talking about robots that’s going to pick up a box off a shelf or doing something autonomous, okay, you can do it.

You you can say that there’s no human person needed, but in healthcare is ridiculous because you know, healthcare is a science, nothing is exact. And even with AI coming, I think it enhances it. It gives them broader perspectives. It can help them do research quicker. It could probably help bring in different types of diagnoses based on the symptoms that’s put in, something that the doctor might not have thought about, or doctors in remote places practicing that doesn’t have the time or the availability to be brought up to date on different types of other types of drugs or procedures out there or how people react to different types of drugs and help maybe bring other drugs to market quicker in other ways.

Like for instance, the GLP1s and GLP2s now that people are talking about like the ozempics and the mangeros for helping with the diabetic diagnosis. And then one of the side effects, I mean, one of the side benefits was the weight loss using those drugs. I, and I’m, I’m, I’m a benefactor of that. I, I’m a, I’m a benefactor of that. But also there was a drug for treating cataracts. And then when they started using that drug to create cataract, they saw that it helped people’s lashes grow longer. So, you know, and, and, and so there are lots of drugs that has, could have various purposes, when, when information gets to be shared more broadly and things can be brought to the forefront more quicker with the enhancement of GenAI.

Building patient-centered health tech

Anmol Satija – Yeah, okay. So of course, I would agree to your points that it definitely acts as an enhancer for overall healthcare delivery. And so Debra, before we, you know, end up our conversation, I would say that your perspective about everything related to interoperability and AI is truly amazing.

And of course, AI has the potential to transform healthcare, but you know, somehow making that it is used in responsibilities, responsibility is also very crucial as the innovations themselves. So now, Debra, one last question would be that you have been at the forefront of healthcare innovation for decades, and navigating these challenges firsthand.

As an entrepreneur in this space, how have you been tackling these obstacles or brainstorming about the new innovation, what is required and what should be built? And more importantly, what have been your driving force behind building products for the healthcare ecosystem?

Debra Griffin – I’m going to read real quick some of the benefits of GNI, and then I’m going to answer your question because that’s how I designed and developed in that space. Enhances patient engagement, which we talked about, through personalized, accessible, proactive treatment plans, tailors content, interactive learning, predictive analysis, supports patients with possibly remote monitoring or telehealth, streamlined processes in entities, symptom checkers, you know, people bring that to their doctor, and then it can help you with medication adherence. My focus has strictly been patient-centric. I see the market evolving to drive down patient or consumer-centric interoperability, and that’s what I understood.

And because that was what I understood, that was what I tried to design and develop from my point of view. From my patients past diagnosis of cancer, but also for my part as being administrators in these healthcare systems, knowing that resources were scarce, trying to figure out how to maximize resources with the minimum of the maximum of care with the minimum of resources with money.

So what I what I wanted to do was make care available to everybody that presented. And I think that in most entities, probably 60 % of the resources maybe go to 20 % of the patients. And that I wanted to try to maximize what was spending because there is going to be a ceiling of where healthcare can put its dollars. And I really think sometimes we’re at that ceiling because a lot of what’s going on in my opinion is not sustainable in terms of dollars being spent. Right.

So what I understood with providers of all kinds using data, their asset, what I understood in terms of Doctors having the will and when I say will or doctors providers, we’re talking about the EHR as we talked about other types of companies I I wanted to make a non-threatening bridge the RID GE to man this fragmentation and the silos and non-threatening meaning that I developed a tool that does does not have a back end for capturing data to be non-threatening just as a bridge to help facilitate data flowing bi-directional from various types of systems, applications, devices. And then I wanted to create another component of how that data is shared uniquely. The two prominent smartphone devices is iPhone and Android. You got Swift and Java.

Debra Griffin – Most people that lean on Java are folks that maybe because those devices are cheaper, don’t have internet plans, maybe like we do. They might have internet cards. I wanted to find a way where they could have access to their medical records and their images without having to burn up their data cards. And so that was my focus, trying to make something generic, but not generic, trying to make something that the market would quickly embrace and adapt to so that it could facilitate interoperability in a quicker way. I don’t know if I’ve done it. I don’t have the solution for interoperability, but I think I have a part of the solution to make it more accessible and non-threatening. And then I made it Moduli Architect.

Because it could change quickly. Business models change quickly. Business models are varied. There’s no set business model. I didn’t want to be a hindrance in that space. And then I wanted to bring what I knew to the table and then give it to the people who are smarter than I am in this space. And they could build upon that and also be able to expand upon that so that it could be adaptable and scale wherever needed.

Anmol Satija – Definitely. Great thought, Debra. And this has been such an insightful conversation. And your work in this space, from advocating for health care access to pioneering solutions that put patients at the center, is definitely inspiring. So as we wrap up, I would like to say one thing, that health care is evolving.

And technology will continue to play a major role in breaking down barriers, improving efficiency, and ultimately saving lives. But innovation isn’t enough. It takes visionaries like you, Debra, who are willing to push through challenges and build solutions that truly make a difference. So thank you for sharing your journey and insights with us today.

Future of healthcare interoperability

Debra Griffin – Thank you, Anmol, for having me. I’d like to leave with a prediction for 2025, 2026 of where I think will be the most movement is going to be wearables because that’s a part of monitoring and patient monitoring. And I think it’s a part of boosting interoperability.

And I think you will see more organizations taking data that wearables produce and integrating it into these legacy systems to help tell a complete story. I’m not naive to think that a holistic healthcare record can be done in one year, two years. I don’t have a time span on it. It takes time for holistic health history, but I do think we need to get on the journey of being very inclusive with those patients and then getting those patients feedback on how does this work? How do they feel about it? And what level of effort did they have to exhort and what’s not acceptable? Because they have to be compliant to make the circle rotate.

Anmol Satija – Yeah, definitely. it’s a very good note to end on. I think your prediction is somewhat in line and is already happening today as well. So thank you for that, Debra. And to everyone listening, if you enjoyed this episode, make sure to subscribe and share the Unthinkable Tech podcast with your network. See you in the next one.