Introducing AppScript on FHIR® for Seamlessly Prescribing Digital Health Apps from Epic Workflows

The IQVIA Institute for Human Data Science report, The Growing Value of Digital Health: Evidence and Impact on Human Health and the Healthcare System, found that Digital Health Apps have tremendous value for patients and health systems. Digital Health Apps have demonstrated clinical benefits in randomized controlled trials (RCTs) across 27 conditions and have the ability to save the US healthcare system billions in avoidable costs each year through more efficient use of acute care and medicines.

However, adoption of Digital Health Apps has not occurred largely due to the inability of health systems to efficiently curate and prescribe apps given their tremendous quantity (~318K), lack of integration with clinician’s electronic health record (EHR) workflows, and an inability to easily measure ongoing clinical value.

Introducing AppScript on FHIR®

Five years ago, IQVIA introduced AppScript to address these problems by providing a single digital health app curation, prescribing, and studies platform.

Today, AppScript by IQVIA is announcing the availability of AppScript on FHIR® on Epic App Orchard. AppScript on FHIR lets clinicians find and prescribe the highest quality digital health apps for their patients from their existing Epic workflow using the AppScript app curation and prescribing tool.

AppScript on FHIR is built on the SMART on FHIR standard and is now available for any health system using Epic 2017 or later and/or any health system supporting the FHIR DSTU2, or later standard. SMART on FHIR is a set of open specifications that integrate apps with EHRs, portals, health information exchanges (HIEs), and other health IT systems. The SMART project defines a health data layer that builds on the emerging FHIR Application Programming Interface and resource definitions.

As part of IQVIA, a Human Data Science Company™, positioned in real-world evidence and clinical trials, AppScript on FHIR will also assist health systems in simplifying research participation by leveraging existing Epic workflows to invite patients to participate in various research studies.

HighPoint will provide AppScript on FHIR technology licenses, as well as associated integration and implementation services to support digital transformation initiatives across their health system clients.

The Value of Digital Health Apps

The benefits of Digital Health Apps — and therefore AppScript — can be measured in clinical outcomes and dollars. In the IQVIA Institute report, we found that Digital Health Apps have demonstrated statistically and clinically significant benefits on hard outcome measures, such as weight loss, HbA1c, Asthma Control Test (ACT), emergency department visits, and hospitalizations in patients living with chronic conditions such as diabetes, respiratory illness, and cardiovascular conditions to name a few.

In the report, we generated a health economic model that we call the AppScript Essentials Value Model, which predicts the associated economic benefits of a handful of apps that have a proven ability to reduce acute care utilization, including diabetes prevention, diabetes management, asthma, pulmonary rehab (for COPD), and cardiac rehab (for myocardial infarction). We found that across these five conditions, the U.S. health care system could save $7 billion per year in avoidable health care costs. Given that Digital Health Apps have been applied successfully to dozens of conditions, we further estimated that Digital Health Apps can save the U.S. $46 billion annually.

While health systems are still struggling with fee-for-service and value-based-care, one thing is becoming increasingly certain: now more than ever, digital medicine is good medicine.

What’s next?

In general, app developers have done a lot of what can reasonably be expected of them. The leading apps, which we call AppScript Essentials, have built apps that demonstrate high usability, robust privacy and security safeguards, strong clinical evidence, and endorsements from objective, third parties, such as the U.S. Food & Drug Administration.

What remains problematic, is the “infrastructure.” This includes privacy/security guidelines, medical malpractice considerations, incentives, and workflow. Most of these items are difficult for individual app developers to address.

The introduction of AppScript on FHIR® on Epic App Orchard is a major step in the direction of providing the required infrastructure to realize the full value of Digital Health.

Learn more about AppScript on FHIR availability via Epic App Orchard.

About the Authors:

Brian Clancy, Co-Lead, AppScript by IQVIA

Brian is Co-Lead and Associate Director, Product Strategy, Marketing and Business Development, with AppScript by IQVIA. His research as the co-author of The Growing Value of Digital Health by the IQVIA Institute has been featured in The Economist, The Lancet, Tech Crunch and Eric Topol’s Twitter feed.

Ann Mendlowitz, Director, Provider Solutions, Highpoint Solutions

Ann is a Provider Solutions Director at HighPoint Solutions. With more than 20 years of health care operational strategy and large-scale Epic and Cerner EHR implementations, Ann leverages her industry knowledge with a client-centered focus serving as a bridge that brings technology and operational teams together. Prior to joining HighPoint, Ann built a superlative Epic practice at Vitalize Consulting Solutions, implemented Epic at more than 300 physician practices for UPMC, and held various leadership roles at Innovative Healthcare Solutions, First Choice Professionals, Leidos and Divurgent.