Sramana Mitra: Let’s do another use case besides the hospital system interoperability. Talk about other use cases where interoperability surfaces as a key issue.
Drew Ivan: The one that is topical right now is reporting COVID test results. The tests happen at laboratories that exist in hospitals or a standalone laboratory. For COVID, they report both positive and negative results. Every time they have a test result, they have to transmit a copy of that result to the public health department.
There is a standard format for doing it based on the HL7 standards. Even with that, there is a lot of manipulation that has to be done because the system that is sending the message may not have exactly the same specification as the system receiving the message.
That is one place that our software can step in to map some of those fields and make sure that they are correct for the receiving systems.
What we are seeing lately is that the number of reportable test results to public health has gone up from a few thousand a month before the pandemic to tens of thousands a month during the pandemic. Just the increase in volume is something that we haven’t seen before in public health.
Sramana Mitra: What is going on in the public health world? You are talking about the COVID test results as an example but there are a lot of issues that have surfaced in public health in the context of this pandemic. There is clinical trial-related stuff. What are you experiencing in your domain within the public health world? Are you seeing an uptick in your technology in this context?
Drew Ivan: Public health departments have been customers for a long time – 10 to 15 years in some cases. The pandemic has changed things in a lot of ways. We are doing a lot of the same things that we have done all along. Electronic lab reporting has been happening for years for other infectious diseases and other reportable conditions.
In a way, there was nothing new to build because the infrastructure was already in place. The part that was not was the volume of test results. There has never been this many lab reports. We were doing 2 million tests a day in the US at the peak. That is a huge number of test results to come in on a daily basis. The volume is brand new.
What we are seeing is a pivot from an emphasis on testing to an emphasis on vaccine administration and recording administration of the vaccine. There is a logistical part of that of how you get the vaccine to where the patients can get it.
There is also an information part of that. How do you record that individual has received the vaccine? How do you know when they need their second dose? How can you confirm if they received both doses? This comes back around to how do you even know who that person is because you have the patient matching problem that we talked about.