00:01.79 Ratnadeep Bhattacharjee Welcome to Leaders Perspective, where we engage with leaders driving the future of healthcare through innovation, policy, and meaningful systems change. I'm your host, Ratnadeep, co-founder at Tech Variable. 00:13.87 Ratnadeep Bhattacharjee Today's episode is titled Trust, Access, and Interoperability in Healthcare. In a world where healthcare data is increasingly digital and distributed, the tension between openness and protection is front and center. 00:27.85 Ratnadeep Bhattacharjee We'll explore how the industry can achieve both seamless interoperability and uncompromising privacy. Joining me today is someone who has been shaping this conversation for over two decades now, Amit Trivedi. 00:40.96 Ratnadeep Bhattacharjee Amit is a nationally recognized expert in healthcare care interoperability, privacy and cybersecurity. He has led national IT certification programs at CCHIT and Verizon's ICSA Labs, served as Senior Director of Informatics and Standards at IMSS and chaired the US Healthcare Standards Collaborative. 01:00.08 Ratnadeep Bhattacharjee Today, he splits his time between consulting on digital health and information exchange strategies and advancing patient and data privacy advocacy efforts through the nonprofit shift collaborative. What sets Amit apart is his ability to see interoperability and privacy not as opposing forces, but as two sides of the same coin, but ah you know essential to creating trusted, equitable, healthy ecosystems. 01:26.80 Ratnadeep Bhattacharjee He brings a system-level view grounded in policy, technical standards and real world implementation. Amit, welcome to Leaders Perspective. It's a pleasure to have you. 01:36.85 Amit Trivedi Well, thank you, and it's a pleasure to be here. really appreciate the invitation. 01:42.55 Ratnadeep Bhattacharjee Amit, you have had a front row seat to the well i mean evolution of interoperability over the last two decades, I believe. To open us up, how would you characterize ah where we are today in terms of interoperability maturity and how do you see the current push towards, you know, TEFCA, FIRE and trusted exchange frameworks playing out? 02:08.18 Amit Trivedi Sure. So we're at a really interesting time in interoperability, both in the United States and and globally. there's ah There's a lot of things happening you know everywhere at the same time right now. 02:20.95 Amit Trivedi But let's let's start with ah what's going on in the U.S., um in a lot of ways, you know, over the last 20 years, um we've been able to set a floor and foundation for interoperability through certifications, through government regulations and interventions like the the various, you know, 21st Century Cures Act, the work around meaningful use, e etc. 02:45.71 Amit Trivedi And so right now, we're at a point where um I think 90% or more of providers in the U.S. have a certified electronic health record, which means that they have um the foundational capabilities to exchange ah electronic prescriptions, labs, patient summaries, and so forth. 03:08.10 Amit Trivedi um And now there's um you know a lot of work happening with TEFCA, the Trusted Exchange Framework and Common Agreement, which is really about setting up a network of networks to really get to that robust last mile level of interoperability. 03:28.37 Amit Trivedi And so TEFCA is really based on having um that floor of standards, um having a shared set of common agreements for data sharing um that are shared across the participants And so it's that mix of policy and technical um work that enables interoperability. 03:53.13 Amit Trivedi Along with Tefka, we have a couple other um interesting pieces that you know add to the puzzle. That's ah the US CDI, which is the US Core Data for Interoperability, which basically sets you know um the minimum level of data, minimum data set that um participants in Tefka um are required to exchange. So you you know we're moving towards requirements to exchange. 04:22.77 Amit Trivedi We have the foundational technology to make it happen. um I think most people, you know, looking at the landscape and how it's evolved over the 20 years um could see, a you know, amazing progress, right? You can pick up your your phone and depending on, you know, what kind of healthcare care network you're working with or you're within, 04:47.84 Amit Trivedi um You can likely get through to through via patient portal. You can get your um basic, ah you know, last visit summaries, meds, et cetera. um What we're working on now, though, really, is um supporting interoperability in a more equitable manner. 05:07.20 Amit Trivedi um It's definitely a world of haves and have-nots. It always has been, right? But healthcare care really is about making sure we deliver that that care um to everybody, not just the the folks that can afford it, um especially when you think about public health, right? 05:24.94 Amit Trivedi And so um key to all of that is privacy and trust in the healthcare care system. And so as much as we focused on interoperability and as much as um we made advances there, um I think what's holding us back at this point is um the the work we need to do around privacy, computable consent, and making sure that that trust is there as we exchange patient health information all over. 05:54.88 Ratnadeep Bhattacharjee Right, right. No, this is this is really interesting considering the fact that, you know, even during my introduction, I kind of said that, you know, privacy and interoperability are, you know, is in the same side of the coin or both sides of the coin. You know, it's an argument that keeps on evolving. You know, there's a perception in the industry that privacy and interoperability are in conflict. 06:18.06 Ratnadeep Bhattacharjee that the more open the data, the less secure it becomes. you you You have kind of argued that these are complementary, not contradictory, right? Can you explain why? You know, how can ah systems be built from the ground up to support both fluid access and probably responsible data stewardship? 06:39.66 Amit Trivedi Well, you know, I love how you put it in terms of responsible data stewardship, right? Because at the end of the day, this isn't just ones and zeros, it's not just data. And at its core, interoperability isn't just about moving data from one place the other, it's about making that data useful, right? 06:57.66 Amit Trivedi And um part of that whole exchange, and you know you see it in the acronym TEFCA, right? Trusted Exchange Framework and Common Agreement. 07:09.98 Amit Trivedi so um you know, there if you really read into that phrase, it's less about the technical piece, and it's more about the the people piece, right? Will you, you know, protect the data that I send you, right? 07:22.76 Amit Trivedi That's basically the premise around interoperability. A lot of, ah you know, the the battles we fought have been around protecting data, right? Like, 07:33.14 Amit Trivedi um Back in the day, it was like, I'm the doctor. this is my These are my patients. This is my data, right? You come and get it if you need it, and I'll verify that individually, right? 07:44.61 Amit Trivedi Now you can you can send um all kinds of data, bulk data, de-identified data, um um individual data with the click of a button and almost to anywhere, right? um and The data can go to third-party data brokers, goes to payers, 08:02.43 Amit Trivedi can go to quality organizations, to the government. um And we've seen all kinds of friction when it comes to data exchange. We can send the data. That's usually not the issue, right? It's it's about um negotiating each one of those integrations, right? 08:21.07 Amit Trivedi And a big part of that is is trust. And so I would i would argue that you know data access versus privacy is kind of a false binary. We really need to do both, um especially in healthcare. care and And we can do both. It's it's not easy, right? 08:38.78 Amit Trivedi Interoperability has never been an easy task. But it's a challenge that we should be up to. And i think if folks look at it and in terms of the way you phrased it, you know responsible stewardship of data, um that that becomes pretty obvious that that you do need to have that that access, the controls, the privacy. 09:00.11 Amit Trivedi Now, why haven't we done it or why why aren't we at that spot yet? um You know, like I said, interoperability has been a challenge. I think our focus has been really on that exchange piece, right? Making sure we can move um images, we can move prescriptions, we can, you know, do controlled substance e-prescribing, you know, we can get a longitudinal patient summary, right? um These are all huge technical challenges, but There is also like, um you know, a method to the madness, right? 09:31.67 Amit Trivedi we've We've moved from faxes to um whole documents to now discrete elements, of data discrete data elements, right? With with the advent of FHIR, fast healthcare, interoperability resources, right? 09:47.45 Amit Trivedi We're moving away from a PDF or a block of text to granular data. And with that comes an opportunity. There's metadata, there's the ability to lock down data, um there's ability to granularly give access to data as well. 10:04.99 Amit Trivedi Now, the the challenge remains Making that technology accessible, implementable um at scale, right? So it's not just a haves and haves not issue, like just because you're in a large medical academic center or you're in a area that has the resources, 10:24.54 Amit Trivedi um or you are a patient in a system that has the resources, that doesn't mean those are the only times you have access to privacy, right? It should be um part and parcel of of the entire ecosystem. 10:40.44 Ratnadeep Bhattacharjee Interesting. Very interesting. I think one of the most important pieces of the puzzle ah in the entire ecosystem is the patient. Patient is the center or probably epicenter of everything that is done in healthcare, right? 10:56.05 Ratnadeep Bhattacharjee Now, one of the important, you know, aspect that you mentioned is longitudinal patient records, correct? So ah let's talk about, and know, consent, you know, let's talk about 11:09.50 Amit Trivedi Bye. 11:09.25 Ratnadeep Bhattacharjee ah patient control in in practice most patients don't fully understand what they're consenting to you know you talk about longitudinal patient records but those records need to be fully understood in terms of what i mean let's say there is a request for data sharing right know the patient should be aware of what they're consenting to right or or or they should understand who really has their data, who really has their data. Is it the provider? Is it the provider company? 11:39.09 Ratnadeep Bhattacharjee Are they use using it for marketing purposes or or whatnot? So how do we move towards a more transparent, equitable and patient-centric model for data access and sharing? 11:52.23 Amit Trivedi Well, you know, that's that's a million dollar question. And I think that's also ah source of big tension, um yeah you know, in the US, ah between states, even globally. um I would point to the, you know, European health data space in terms of how they're approaching the use and exchange of, or the secondary use of of health data, right? 12:18.07 Amit Trivedi They've actually classified primary and secondary use, and they have different requirements for exchange based on that. um In the U.S., it's it's a little bit different, and I would argue there's a bit of a black hole when it comes to exchange. 12:33.96 Amit Trivedi any patient, I would even challenge most providers, um you know, knowing where that data is going once it's sent. um You know, it's one thing to broker these agreements, um decide to, ah you know, exchange information either directly with a provider or with an HIE or your partners. But But the information um definitely can can go other places. And we don't have the the mechanisms to really track, trace, and audit that data and get that information back to the patient. 13:08.88 Amit Trivedi um I'd argue that we do have the technology and the means to, right? um We see it in lots of other industries. um But the the the healthcare care industry has been you know lagging behind on that. 13:20.49 Amit Trivedi And, you know, there's there's many reasons why. um Part of it is, you know, um the patient is often disenfranchised, you know, in the whole interoperability ecosystem. 13:33.05 Amit Trivedi um You know, we're all patients at the end of the day. um But at some point you enter the system and you become part of the process. whether um and And so I think one of the issues is being able to explain consent um in in a better way, right? We've all checked a box, whether it's for you know licensing or at the doctor's office or wherever without reading 17 pages of legal documents. 14:03.68 Amit Trivedi um That's actually something that we're working on in a nonprofit that I'm working with, the SHIFT Collaborative that you referenced. you know Our focus there is empowering patient-directed health information exchange and supporting ah the advancement of standards for granular privacy protection. 14:25.70 Amit Trivedi So, you know, if you as the patient feel data is sensitive, whether that's behavioral health data, substance use um data, whether it's even your address that you want to keep out of um the hands of perhaps, you know, other folks, um patients should have that ability to to deem that data sensitive and our technology should have the capability to um to be able to handle that data. 14:53.91 Amit Trivedi Some of those basic requirements are part of the certification standards, right? But they're optional. And, you know, one of the things I know from having tested and certified, you know, almost all the yeah EHR vendors out there is that um um requirements go into production or functionalities go into production when they're tested and when they're um more often than not required by regulation, right? 15:22.39 Amit Trivedi so um making a requirement optional is a good signal to the industry that it should be something that folks should pay attention to but often these are things that are pushed off until they become a burning requirement right with all that's that's going on so um yeah 15:40.52 Ratnadeep Bhattacharjee Yeah. 15:44.02 Ratnadeep Bhattacharjee Understood. ah One of the things that you touched upon, Amit, is, ah you know, that you were involved in certifying, you know, various HIT platforms or EHRs and whatnot, right? So what really, you know, from your experience of working on that front, what really goes into it, right? You know, 16:05.71 Ratnadeep Bhattacharjee What does it take to get ah platform certified as an HIT certified a entity or a product or whatever you call it? 16:17.03 Amit Trivedi All 16:16.17 Ratnadeep Bhattacharjee What what does it take? like What are the processes and ah what are the technical requirements and specifically to get these platforms certified? 16:25.53 Amit Trivedi all right. Well, you've hit, you know, a interesting spot for me. and So because I spent about 15 or so years doing testing and certification, I could probably talk about that in three more episodes, but I'll try to keep it, you know, concise. 16:42.17 Amit Trivedi um But But I'm gonna start back about 20 years ago. um So 20 years ago, you know the landscape was folks were implementing different health IT products and you know it was a rip and replace routine. 16:58.40 Amit Trivedi Not only the products, but the CIO, right? You put in a product, you do an implementation for three to five years, it bombs, replace the product, replace the CIO, next rinse and repeat. 17:12.43 Amit Trivedi um The industry was looking for some sort of assurance that, you know, the product that you buy is going to work when you implement it. um Back, you know, those about those two and decades ago, um the US s looked to Canada who had implemented, you know, the first voluntary certification program. 17:32.61 Amit Trivedi We nabbed some of the consultants and put together the first voluntary certification program. That was the Certification Commission for Health IT. um Basically, vendors from across you know the ecosystem got together, um vendors, other stakeholders too, provider organizations, providers, and put together the first set of requirements for an inpatient and then ambulatory yeah EHR. 17:59.51 Amit Trivedi And so that began voluntary certification. The government and voluntary certification was really a marketing tool to differentiate your EHR or health IT product from another. 18:12.57 Amit Trivedi um Once the federal government stepped in with meaningful use and the, um, as part of the high tech and American recovery and reinvestment acts, um which was really a big economic stimulus. um they They injected a lot of funds into supporting meaningful use, um getting certified technology in the hands of providers. 18:39.07 Amit Trivedi So this first round of certification, and I, went through many rounds of it from, you know, launching the first rounds to going through the, you know, meaningful use and beyond. 18:50.70 Amit Trivedi The first round was really about getting providers to adopt or purchase really just license technology. If you license the technology and show that you had the receipt and it was certified, um you were eligible to get your incentive dollars. 19:08.95 Amit Trivedi I have different opinions about that. I think it could have been done better. And part of it, um, could have been that that the program was much more stringent when we started, right? But we had to start with somewhere. 19:20.28 Amit Trivedi did, we did certify and test hundreds of vendors, but that first stage of meaningful use um and the first certification requirements were a pretty low bar, right? 19:32.39 Amit Trivedi um And this was the first time we were testing products nationally for healthcare care under the federal um federal government. And so, you know, as a testing body, 19:46.05 Amit Trivedi We were dealing with things like um you know using testing processes and methods developed by NIST to test you know hardware, like ah bulletproof vests or you know um yeah you know hardware, not software. So we were actually transforming the industry in terms of how do you test and certify software products, which include making changes to software and updates and new versions, all that. And so um on top of that, you know, it was a multi-year process where they also injected new standards, new requirements, new functionalities year over year. 20:24.07 Amit Trivedi And so, you know, looking at a 2011 certified product versus 2021, You know, I think the last one is a 2015 edition, which speaks to how long that was, but there have been incremental updates to it. 20:37.06 Amit Trivedi there There is a massive difference in what kind of that first certified product could do versus what products that are fully certified can do today. um it's it can be um For a a new player, it can be a significant effort, right? 20:52.83 Amit Trivedi um For many of these things, whether it's certification, whether it's approaching integration with a new partner, whether it's adopting a new standard or um implementing new regulations, 21:07.44 Amit Trivedi It's hard to do this on your own, right? um this That's why there's a huge um economy and um profession around consulting, right? Because you need to find the expertise to you know support your organization so you can do what you do best. 21:24.58 Amit Trivedi um As you can tell, like I'm talking about things that many people are are probably not as familiar with, you know especially the deep certification and testing pieces, but um it does help to partner with and hire experts to get you through some of these processes. 21:40.27 Amit Trivedi That said, it's not an easy one, but it's very doable. And all the information is out there. on the ONC site in terms of test procedures, standards to read the scripts. 21:51.68 Amit Trivedi You know, we would say it's an open book test. And i used to always, you know, get upset that folks would fail so hard on these tests when it was open book. But that said, it's, it um I understand from the other end too what that looks like, right? 22:08.59 Amit Trivedi the The CIO or product manager or even the marketing you know chief says you need to go get certified. They carve out a budget, hand the requirement over to the developers, and you know they're on their own. 22:23.61 Amit Trivedi And it's a daunting task to go through the various requirements, reading and understanding standards and implementation guides. Not easy, not fun. 22:35.73 Amit Trivedi um The fact that we're looking at and and using FHIR with fast healthcare interoperability resources, that that's been a boon to healthcare in terms of a more modern development environment that today's software developers will you know can gravitate towards to. 22:56.43 Amit Trivedi However, there's still a challenge in that the the world is largely still an h l seven v two and CDA world, you know. And so as much as we love to go to FHIR or be FHIR native in everything we do, that's just not... 23:12.29 Amit Trivedi the way the US works today. and so Most health systems are you know deeply grounded in HL7v2, pipe delimited messages. 23:23.79 Amit Trivedi and Then also, because of meaningful use, because of 10, 15 years of standards requirements, um CDAs for or consolidated document architecture standard for um for patient summaries. So really um going back to the certification piece, 23:43.12 Amit Trivedi um you You know, getting through the testing and meeting all the requirements is one thing. Understanding which requirements that you want to actually test and certify it to is another thing. Not everyone is a ah ah full EHR. 23:56.75 Amit Trivedi um i mentioned it was a marketing um tool to begin with, you know, providing assurance to your purchasers or to your partners that you do what you're supposed to do. 24:07.56 Amit Trivedi And the federal government is also monitoring thats ah that certification. So I'll talk about that in a second as well. But, um you know, for many companies, it's about um aligning their key functionality to what their customers need and making sure that there that functionality is certified. 24:30.59 Amit Trivedi um So um there's ah there's a little bit of, you know, inside knowledge that's required just to know um what your customers need really and then also how to align that with what you already do if you're going to serve as their partner. 24:47.98 Amit Trivedi And the last thing I want to mention about certification, though I could probably mention a lot more, is that maybe the hardest part about certification isn't just passing the test and getting certified, it's ensuring that you can maintain your certification, right? 25:02.62 Amit Trivedi So um over the years, they've really beefed up that that portion, the surveillance, um the conditions of certification. So there's a ah host of things you need to do to maintain your certification. 25:15.92 Amit Trivedi including providing some pricing transparency, including addressing any issues that come up. um And then also in some cases, and and they've changed some of the requirements for this, um providing information of how you do real-world testing for your product to ensure that the product works and an implemented um works when it's implemented just like it was when it was tested. 25:44.95 Ratnadeep Bhattacharjee Interesting, honestly brought back a lot of memories because a few years back we actually worked with one of our clients in getting, although it's ah on a different tangent, not really, you know, getting certified as an HID product, but we got our, you know, client NCQA certified for a few HIDIS measures and we, I can totally understand how difficult it was, you know, with all the test tags and everything, you know, preparing everything for the test deck and then you know making sure that your ports and everything run properly. So it it was it was a hell of a journey, but a journey where we learned a lot for sure. 26:23.35 Ratnadeep Bhattacharjee But you know ah um i mean continuing to ah the you know discussions that we're having. ah Now, from a system architecture point of view, I know you touched upon it a little bit in your previous answer or one of your previous answers, but I also wanted to understand right you know from a system and architecture point of view, what do the next generation guardrails for privacy and security look like? right ah For example, know for example you know zero trust architectures, role-based access, consent-based APIs, metadata tagging and and audit trails and whatnot. So what are your views on those? 27:04.44 Amit Trivedi Well, I mean, I think it's, they they become more important than ever, right? You mentioned, you know, auditing, tracing, metadata, um you know, it's all about context, right? Like, so I talked about FHIR and the ability to move from ah document um to granular data, right? 27:26.59 Amit Trivedi And so, um The promise of that is that you don't need the full document. um You need to transfer all that data to an app that's only monitoring you know um cholesterol. 27:38.84 Amit Trivedi right You maybe just need to send the latest ah reading. But part of that is you also need to send the me metadata around that, which could include how that that data was collected, where it comes from, 27:54.86 Amit Trivedi what kind of sensitivity it has, all of that, right? And so in a way, everything always gets more complicated. So now we have we're down to one piece of granular data, but then there's the whole metadata and the context around it, which really gives that data the ability to be used. 28:12.68 Amit Trivedi Otherwise, it's just a number, right? And so when we look at things like um generative ai or um large language models, right, it's all about The training um data sets right, what did you train your your machine or model on so comes back to good data and bad data, which has always been, you know, one of the issues around healthcare care so. 28:37.17 Amit Trivedi um On one end we're able to take massive amounts of data and move them around anywhere. um On the other end, it's harder to gain context and understanding of what that data is. So there's a lot of work um being put into defining the metadata models and ensuring the tagging and all of that um is is in place. And this becomes really important in the privacy conversation as well. And so one of the efforts we're working on in Shift with h l seven 29:10.55 Amit Trivedi is updating the the library of sensitive tags and sensitive flags that we use within the data. And you think, well, you know, 29:21.81 Amit Trivedi don't we have this already? um And we do in some kind of um context, but not in others. and And so let me explain that, right? Like, so if you have medication data, it could be regular clinical medical data, or it could be sensitive data if it's tied to behavioral health, sexual dysfunction, or other things, right? Reproductive healthcare, 29:49.12 Amit Trivedi um And so now you are entering sensitive data um realm, which is now also being regulated. So whether it's um behavioral health data that's regulated 42 30:05.57 Amit Trivedi or whether it's reproductive health data, which up till recently was regulated under HIPAA, but now is being regulated state by state um as there's you know a little bit of a Dysfunction and and you know patchwork regulations that are popping up around privacy with differing views, you know, on national local state by state. 30:33.00 Amit Trivedi And so um I would argue, you know, um auditing um provenance right of where the data comes from. is more important than ever. And so these are the areas people really need to pay attention to. um And then it comes back to, you know, auditability, um access controls. 30:54.84 Amit Trivedi You know, when when we talk about things like zero trust, um you know, at HIMSS, where I was previously, we did many, many webinars on, you know, zero trust, on um helping advance, help ah you know, cybersecurity within healthcare organizations. 31:11.80 Amit Trivedi But, you know, that's that's also a tough tough area to work in, right? It's one thing if you're, you know, um you know, a ah data provider, right? 31:23.21 Amit Trivedi Or, you know, working with, you know, you're a software company. It's another thing if you're and actual hospital or a clinic, um you know, the like the levels of security and understanding of security you you know, it it really varies from from institution to institution. 31:42.51 Amit Trivedi And at the end of the day, even the the institutions that know everything don't have the resources to implement it, right? So it's really about trying to figure out, you know, and this may be the the state of healthcare care in the general in general, right? Like picking the low hanging fruit, trying to prioritize and do as much as you can with the resources you have, right? 32:05.71 Amit Trivedi and Again, this is where I think we're where we are in terms of interoperability and privacy. For 20 years, I've heard, you know, this is too complicated. There are easier things we can do, or my customers aren't asking for that. 32:21.26 Amit Trivedi You know, whether can talk about it, whether it's privacy. i heard the same thing for patient summary, right? My patients aren't asking for a patient summary. Now, this is mostly because most patients didn't know they could get a patient summary, right? 32:36.24 Amit Trivedi But there's plenty of reasons not to do things until there's a regulation. But um healthcare care is really about trust, right? And so i would I would say to those organizations that are looking to be leaders in the space, you know, don't just look at the the minimum requirements. Don't just look at the law. Look at the intent. 32:56.08 Amit Trivedi and look at what you're supposed to be doing. And then you'll you'll wind up ahead of the curve and probably be in a position to you know win more business. 33:07.43 Ratnadeep Bhattacharjee Wow, I was just coming, i mean, as as a final question or final, you know, kind of interaction that I wanted to have with you. I really wanted to know, 33:19.53 Ratnadeep Bhattacharjee especially from someone who has been in this industry for the better part of two decades, right? For healthcare leaders, policy architects, or digital health founders, especially tuning into this podcast, what's your single biggest piece of advice for building systems that scale trust as much as the scale access? 33:42.76 Amit Trivedi Well, so if we're talking about trust, if we're talking about building, we're talking about scaling, the one thing I would say is like you can't do it alone. You know, healthcare care isn't a one person, one entity shop. Interoperability isn't about one entity. 33:58.41 Amit Trivedi You need partners, you you you know. And so part of that, I would say, is, um you know, engage in the community and find ways, you know, to collaborate. 34:10.17 Amit Trivedi um You know, this this goes back to the idea of data exchange and interoperability in general. So many times in, you know, in all my conversations with folks, the issue has been, well, we send all this data, but we never get anything back, you know. 34:25.69 Amit Trivedi And so I think that's that's part of the issue, right? Like, you need to not, you need to, send stuff, but you need to give back as well. And so I think one of the ways you can do that is participate in in these different activities. Now, I spent many, many years working with standards groups, which are many, you know, volunteer-led activities. 34:49.44 Amit Trivedi They're volunteer led, but often government funded or supported. and also every big vendor or you know folks who are players in the space are watching, right? And they're participating at different levels, right? 35:04.84 Amit Trivedi um They may not always talk about it, they won't promote it, but they'll always be watching and looking at what technology is coming around the corner. The smartest ones are implementing it before it becomes a requirement so they can get ahead of the requirement. 35:20.11 Amit Trivedi If you're implementing before the requirement, you can also comment intelligently in terms of what works and what doesn't. And that also raises your profile in terms of you know thought leadership within the space. But my biggest thing would be find ways to get involved. And there's so many different avenues right internationally nationally um you know i'll mention a couple different groups there's hl7 international so many different working groups on so many different areas from you know granular segmentation of data to sensitive flags to you know ah medic you know you name it um there's a there's a group for every standard but 36:04.13 Amit Trivedi um Beyond HL7, there's my group, the Shift Collaborative. you know We have work streams for um technical folks, policy wonks, um people who are involved in ethics, patient advocates, patients themselves. right I mentioned that often patients are disenfranchised from the whole system. you know I mean, for me, um you know, I've approached this as more of a technologist and then later as like, oh, this is not just technology, it's policy. 36:38.47 Amit Trivedi But often i don't put on my patient hat either. Like I don't actually want to be a patient. So um that's part of the issue. But we need to have those folks involved in the conversation and we need to share that info. And so I think um And then the reason I mentioned standards is because it's foundational. 36:56.96 Amit Trivedi That's where you'll really get access to a lot of the the folks I feel are the the ones driving, you know, the conversations around data exchange, architecting the new systems, and the folks who know what works and what doesn't work and why. 37:17.99 Ratnadeep Bhattacharjee Right. ah You know, Amit, this has been one of the most grounding and rather insightful conversation we've had on leaders' perspective. 37:27.71 Amit Trivedi I appreciate that. 37:27.52 Ratnadeep Bhattacharjee and thank you for thank you Thank you so much for bringing such clarity, depth and balance to a topic that sits right at the heart of you know healthcare care transformation. 37:39.22 Ratnadeep Bhattacharjee To all our listeners, if you found value in this conversation, please subscribe and share the episode with your network and if you're working on interoperability or digital trust in healthcare, definitely check out the work being done by Shift Collaborative. 37:55.56 Ratnadeep Bhattacharjee Before we wrap up, where can people connect with you or follow your work, Amit? 38:00.90 Amit Trivedi Sure. um you can You mentioned the SHIFT Collaborative, so I would say www.shiftinterop.org. That's our website. We're very open. 38:11.86 Amit Trivedi We're always looking for folks to volunteer or get involved. And then we're also very interested in sharing our work with other people. You can also find me on LinkedIn. You can... 38:23.82 Amit Trivedi Google Amit Trivedi. There's a good chance you might get the other more famous Amit Trivedi, but you know if you look hard enough, you'll find me. you can You can look for standards or interop. 38:37.58 Ratnadeep Bhattacharjee Correct. You know, people will find the musician, but, you know, I can see a guitar at the back end, probably, you know, you are not too far off. 38:45.85 Amit Trivedi Yeah, i I can close with this ah final thing. So I'm also a musician, not quite at the caliber and level of Amit Trivedi, the greater, but I sometimes get his fan mail. 38:58.30 Amit Trivedi And so I'll tell you the same thing that um I tell them, you know, never give up on your dreams. 38:59.78 Ratnadeep Bhattacharjee Okay. 39:06.23 Ratnadeep Bhattacharjee yes a definitely definitely and that's a great you know segue to ah the end of the podcast right thanks again Amit and thanks to all of you for listening this is Ratnadeep and you have been listening to Leaders Perspective until next time stay curious stay collaborative and stay trusted thank you 39:16.24 Amit Trivedi All right.
