For those of us who have spent the last decade navigating the intersection of healthcare and IT, one thing has remained stubbornly constant: healthcare data availability is complex. Data is trapped in silos, locked behind proprietary vendor doors, or buried in legacy systems that do not like talking to each other.
We have spent years trying to solve all this – but the tide is finally turning. At Cadasto, we are excited for a future in which standardised open data platforms become the norm in healthcare IT and will open the way for limitless innovation. However, we also see that for many healthcare regions and collaboratives, it will be ideal to leverage multiple platforms. But how does this not lead to yet another kind of fragmentation? The answer is federation. We are keen to share what this is and to introduce the latest addition to the Cadasto portfolio: the Cadasto Federation, our solution to intelligently connect multiple openEHR Clinical Data Repositories (CDRs) into a single, coherent, patient-centric view.
What Do We Mean by Federation?
Cadasto’s main offering is, of course, an ‘open data platform’ also often referred to as a ‘clinical data repository’ (CDR). Such a platform is, in very basic terms, a standardised environment for data to live in. This data is modelled, in our case according to the openEHR standard, to ensure optimal reusability and interoperability. A federation is something altogether different. It is the connective tissue that sits above multiple of such environments.
It allows you to treat multiple, separate, and disparate platform databases as if they were one single source, without actually moving the data. When a clinician or researcher performs a search, the federation layer queries all connected sources and fetches the relevant information from all. It provides a single point of access to a distributed landscape, allowing search, read and write actions.
Why This Matters for Healthcare Organisations and Regions
Historically, getting a complete, unified, up to date picture of a patient’s relevant information is notoriously difficult. Extracting data from multiple sources is often time-consuming and even when this data is available, different sources usually do not speak the same language. Terminology and parameters differ, leading to semantic challenges on top of the logistical ones.
The Cadasto Federation changes the game in four key ways:
- Data Stays at the Source
This is a huge win for governance and GDPR compliance. When data remains at the very source where it was created, the ‘data ownership’ remains clear. Endless amounts of data copies are a compliancy nightmare. When the data stays at the source but can still be made available on request by those with the right authorisations, such data copies are no longer required. - Real-Time Insights
Because you are querying, reading and writing the source systems directly, the information is always up to date. Whether it is a clinician checking a medication list or a manager looking at bed capacity across a region, they are seeing the truth as it exists now. - True Multi-Vendor Interoperability
Healthcare IT is, by necessity, a patchwork quilt of systems and applications. Even at the level of standardised data, your organisation needs choice and the option to use multiple open platforms in tandem to leverage the strengths of multiple ones. A federation layer connects to such a combination of data platforms and provides access to the data in all, as required and authorised. - Cascade
The Cadasto Federation also allows for a ‘cascade’ effect. This means that a federation can itself become a source for another federation. For example, a group of local hospitals can federate their data into a sub-regional hub, which then feeds into a larger regional or national oversight layer. This creates a scalable, hierarchical architecture where data is accessible at every level of the healthcare system without ever needing to be duplicated or physically moved up the chain.
Where Federation Shines: Top Use Cases
We are seeing incredible potential for the Cadasto Federation in several specific areas:
- One Organisation, Multiple Open Platforms / CDRs
Many organisations will want to leverage the specific strengths of multiple open data platforms. Federation allows that organisation to draw data from each connected platform and perform read/write actions as needed. - Regional Shared Care Records
Imagine a world where a GP, a specialist, and a social worker all have access to all relevant information concerning a patient and their treatment, even though their data sits in three different data platforms. The federation layer pulls the relevant information together in real-time to create that view. - Clinical Research and Trials
For researchers, finding the right patient cohort can take months. With a federation layer, they can run a query across multiple databases simultaneously (with the right permissions) to find eligible participants in seconds. - Population Health Management
To understand how a chronic disease is affecting a region, you need data from everywhere. Federation allows for ‘distributed analytics’: you get the high-level statistics you need by querying the sources where they sit, without ever having to move sensitive individual patient files into a new environment.
How to Get Started
Adopting a federated approach is as much about mindset as it is about technology. Here are three tips to help your organisation prepare:
- Prioritise Standards
Federation can only work when data speaks a common language: openEHR. Focus on implementing standards openEHR wherever possible, for clean, modelled clinical (and demographic!) data. - Think Small, Scale Fast
Do not try to federate every single system in the region on day one. Pick a specific use case (perhaps sharing pathology results across two different Trusts) and prove the value of the federated approach there first. - Governance
The technology is the easy part; getting different organisations to agree on data access rules is the hard part. Start those ‘data sharing agreement’ conversations early and get everyone on the same page.
Contact Us for a Demo
We are looking for forward-thinking healthcare organisations to help us shape the future of interoperability. We believe that by keeping data at the source and connecting it intelligently, we can finally break down the silos that have held healthcare back for decades.
We would love to show you how the Cadasto platform and Federation can transform your data strategy. Get in touch with us today for a personal demo and let’s discuss your specific needs and challenges, so we can help you transform your IT landscape and make it future-proof.
