Tag: 17/3/25

The Future of Healthcare Interoperability: Building a Stronger Foundation for Data Integration

Henry Adams, Country Manager South Africa, InterSystems

Healthcare data is one of the most complex and valuable assets in the modern world. Yet, despite the wealth of digital health information being generated daily, many organisations still struggle to access, integrate, and use it effectively. The promise of data-driven healthcare – where patient records, research insights, and operational efficiencies seamlessly come together – remains just that: a promise. The challenge lies in interoperability.

For years, healthcare institutions have grappled with fragmented systems, disparate data formats, and evolving regulatory requirements. The question is no longer whether to integrate but how best to do it. Should healthcare providers build, rent, or buy their data integration solutions? Each approach has advantages and trade-offs, but long-term success depends on choosing a solution that balances control, flexibility, and cost-effectiveness.

Why Interoperability Remains a Challenge

Despite significant advancements in standardisation, interoperability remains a persistent challenge in healthcare. A common saying in the industry – “If you’ve seen one HL7 interface, you’ve seen one HL7 interface” – illustrates the lack of uniformity across systems. Even FHIR, the latest interoperability standard, comes with many extensions and custom implementations, leading to inconsistency.

Henry Adams, Country Manager South Africa, InterSystems

Adding to this complexity, healthcare data must meet strict security, privacy, and compliance requirements. The need for real-time data exchange, analytics, and artificial intelligence (AI) further increases the pressure on organisations to implement robust, scalable, and future-proof integration solutions.

The Build, Rent, or Buy Dilemma

When organisations decide how to approach interoperability, they typically weigh three options:

  • Building a solution from scratch offers full control but comes with high development costs, lengthy implementation timelines, and ongoing maintenance challenges. Ensuring compliance with HL7, FHIR, and other regulatory standards requires significant resources and expertise.
  • Renting an integration solution provides quick deployment at a lower initial cost but can lead to vendor lock-in, limited flexibility, and escalating costs as data volumes grow. Additionally, outsourced solutions may not prioritise healthcare-specific requirements, creating potential risks for compliance, security, and scalability.
  • Buying a purpose-built integration platform strikes a balance between control and flexibility. Solutions like InterSystems Health Connect and InterSystems IRIS for Health offer pre-built interoperability features while allowing organisations to customise and scale their integration as needed.

The Smart Choice: Owning Your Integration Future

To remain agile in an evolving healthcare landscape, organisations must consider the long-term impact of their integration choices. A well-designed interoperability strategy should allow for:

  • Customisation without complexity – Organisations should be able to tailor their integration capabilities without having to build from the ground up. This ensures they can adapt to new regulatory requirements and technological advancements.
  • Scalability without skyrocketing costs – A robust data platform should enable growth without the exponential cost increases often associated with rented solutions.
  • Security and compliance by design – Healthcare providers cannot afford to compromise on data privacy and security. A trusted interoperability partner should offer built-in compliance with international standards.

Some healthcare providers opt for platforms that combine pre-built interoperability with the flexibility to scale and customise as needed. For example, solutions designed to support seamless integration with electronic health records (EHRs), medical devices, and other healthcare systems can offer both operational efficiency and advanced analytics capabilities. The key is selecting an approach that aligns with both current and future needs, ensuring data remains accessible, secure, and actionable.

Preparing for the Future of Healthcare IT

As healthcare systems become more digital, the need for efficient, secure, and adaptable interoperability solutions will only intensify. The right integration strategy can determine whether an organisation thrives or struggles with inefficiencies, rising costs, and regulatory risks.

By choosing an approach that prioritises flexibility, control, and future-readiness, healthcare providers can unlock the full potential of their data – improving patient outcomes, driving operational efficiencies, and enabling innovation at scale.

The question isn’t just whether to build, rent, or buy – but how to create a foundation that ensures long-term success in healthcare interoperability.

Innovative In Vivo Imaging Offers New Treatment and Hope for Chronic TMJ Pain

Photo by engin akyurt on Unsplash

Facial pain and discomfort related to the temporomandibular joint (TMJ) is the second-leading musculoskeletal disorder, after chronic back pain, affecting 8% to 12% of Americans. Current treatments for TMJ disorders are not always sufficient, leading researchers to further explore the vast nerve and vessel network connected to this joint – the second largest in the human body.

In a study published in December 2024 in the journal Paina research team led by Yu Shin Kim, PhD, associate professor at the The University of Health Science Center at San Antonio (UT Health San Antonio), observed for the first time the simultaneous activity of more than 3000 trigeminal ganglion (TG) neurons, which are cells clustered at the base of the brain that transmit information about sensations to the face, mouth and head.

“With our novel imaging technique and tools, we can see each individual neuron’s activity, pattern and dynamics as well as 3000 neuronal populational ensemble, network pattern and activities in real time while we are giving different stimuli,” said Kim.

When the TMJ is injured or misaligned, it sends out signals to increase inflammation to protect the joint. However, this signaling can lead to long-term inflammation of the joint and other parts of the highly connected nerve network, leading to chronic pain and discomfort. About 80% to 90% of TMJ disorders occur in women, and most cases develop between the ages of 15–50.

Activation at the cellular level

Previous animal studies observed behavioural changes related to pain, but this study was the first to record reactions at the cellular level and their activities. To see which portions of the nerve pathway respond to various types of pain, Kim’s team created different models of pain and observed the neuronal activity with high-resolution confocal imaging, which uses a high-resolution camera and scanning system to observe neurons in action.

The team discovered that during TMJ activation, more than 100 neurons spontaneously fire at the same time. Activation was observed in localised areas of the TMJ innervated to TG neurons. The localisation of this activation highlights the specific neural pathways involved in TMJ pain, offering deeper insight into how pain develops and spreads to nearby areas. The study is also the first to quantify the degree of TG neuronal sensitivity and network activities.

Potential link to migraine, headaches

Chronic TMJ pain in humans is often linked to other pain comorbidity such as migraines and other headaches. Kim’s team observed this crossover in the in vivo model as inflammation of TG neurons spread to the nearby orofacial areas. Kim’s previous research demonstrated how stress-related migraine pain originates from a certain molecule, begins in the dura and innervates throughout the dura and TG neurons. This current study and novel imaging technique further reveals potential connections between the TMJ, migraines and other headaches.

Potential of CGRP treatment

Calcitonin gene-related peptides (CGRP), molecules involved in transmitting pain signals and regulating inflammation, are often found in higher amounts in synovial fluid of TMJ disorder patients. Synovial fluid surrounds joints in the body, helping to reduce friction between bones and cartilage. Higher amounts of CGRP are often associated with increased pain and inflammation. Kim hypothesised in this study that a reduction in CGRP may reduce TMJ disorder symptoms. He found that CGRP antagonist added to the synovial fluid relieved both TMJ pain and hypersensitivity of TG neurons.

Currently, there are no Federal Drug Administration-approved medications for TMJ disorders other than non-steroidal anti-inflammatory drugs (NSAIDS). While some CGRP antagonist medications are FDA-approved for treating migraines, this study suggests these drugs may also provide relief for TMJ disorders. Confirmation of the positive effect of the drug on TMJ pain is a major leap forward in understanding how CGRP affect TMJ pain, said Kim.

“This imaging technique and tool allows us to see pain at its source – down to the activity of individual neurons – offering unprecedented insights into how pain develops and spreads. Our hope is that this approach will not only advance treatments for TMJ disorders but also pave the way for understanding and managing various chronic pain conditions more effectively,” said Kim.

Source: University of Texas Health Science Center at San Antonio

Dopamine has an Unexpected Role in Memory Devaluation

Photo by Fakurian Design on Unsplash

New research out of Michigan State University expands on current understanding of the brain chemical dopamine, finding that it plays a role in reducing the value of memories associated with rewards. The study, published in Communications Biology, opens new avenues for understanding dopamine’s role in the brain.

The research team discovered that dopamine is involved in reshaping memories of past rewarding events – an unexpected function that challenges established theories of dopamine function.

“We discovered that dopamine plays a role in modifying how a reward-related memory is perceived over time,” said Alexander Johnson, associate professor in MSU’s Department of Psychology and lead researcher of the study.

In the study, mice were presented with an auditory cue that had previously been associated with a sweet-tasting food. This led to a retrieval of the memory associated with consuming the food. At this time, mice were made to feel temporarily unwell, similar to how you feel if you’ve eaten something that has upset your stomach.

When the mice had fully recovered, they displayed behaviour as if the sweet-tasting food had made them unwell. This occurred despite the fact that when mice were made to feel unwell, they had only retrieved the memory of the food, not the food itself. This initial finding suggests that devaluing the memory of food is sufficient to disrupt future eating of that food.

The research team next turned their attention to the brain mechanisms that could be controlling this phenomenon. Using an approach by which they could label and reactivate brain cells that were engaged when the food memory was retrieved, the researchers identified that cells producing the chemical dopamine appeared to play a particularly important role. This was confirmed through actions that manipulated and recorded dopamine neuron activity during the exercise.

“Our findings were surprising based on our prior understanding of dopamine’s function. We typically don’t tend to think of dopamine being involved in the level of detailed informational and memory processing that our study showed,” Johnson explained. “It’s a violation of what we expected, revealing that dopamine’s role is more complex than previously thought.”

The team also used computational modelling and were able to capture how dopamine signals would go about playing this role in reshaping reward memories.

“Understanding dopamine’s broader functions in the brain could provide new insights into how we approach conditions like addiction, depression and other neuropsychiatric disorders,” said Johnson. “Since dopamine is implicated in so many aspects of brain function, these insights have wide-ranging implications. In the future, we may be able to use these approaches to reduce the value of problematic memories and, as such, diminish their capacity to control unwanted behaviours.”

Source: Michigan State University