Martin Tiani, CEO of Tiani Spirit, the global leader in Integrating the Healthcare Enterprise (IHE), discusses the importance of interoperability within electronic health information exchange (HIE) and the challenges e-health faces, especially for the company as they adapt to differing regulations in various nations. Furthermore, he highlights the grapevine initiative (grapevineworld.com) for global IHE standards-based solutions and the benefits of a long-term partnership with global powerhouse Cisco, as well as a look into the company’s innovative technologies for the future.
What was your vision when you founded Tiani Spirit?
“When encompassing an e-health record you must combine a huge range of 40 to 50 standards; IHE is able to select those standards in an extremely sensitive manner.”
The journey started in 1991 when I co-founded Tiani Medgraph AG in the field of radiology, and after selling this company in 2003, we relaunched as Tiani Spirit in 2004 with the intention of building up software infrastructure as the basis for an electronic health (e-health) record. Since the beginning the key focus of Tiani Spirit has always been aligned with the methodology of IHE and standardizing systems to maintain interoperability [i.e. the ability of computer systems or software to exchange and make use of information]. This is the key to closing the links of the value chain and ensure connectivity between all stakeholders within the healthcare ecosystem.
When encompassing an e-health record you must combine a huge range of 40 to 50 standards; IHE is able to select those standards in an extremely sensitive manner. IHE profiles the situation, then specifies what standards should be put in place, allowing all parties involved to have a specific tailored product while in the meantime ensuring they are connected at all times. The goal of Tiani Spirit was always to be number one in IHE globally, and for the last nine years we have achieved this objective. Our goal now is to connect as many stakeholders as possible.
Within which sectors are you applying your IHE technology?
To expand our reach, we have set up grapevine, which reuses the underlying theory of profiling and IHE methodology of Tiani Spirit within healthcare. This has opened up the possibility to enter into other verticals, such as energy and finance. grapevine enables existing providers to become a part of grapevine and to create collectively the international grapevine backbone to exchange data independent of the verticals, while including all market players and taking into consideration the differing marketplaces and data protection regulations.
Furthermore, this initiative has allowed us to balance the economic strengths. For example, physical products like clothes are generally produced in less prosperous nations, with the bulk of profits being distributed between traders in the affluent nations. With grapevine we help facilitate the sale of software from these less prosperous nations by considering the GDP (gross domestic product) and therefore, allowing companies to earn significantly more by utilizing the grapevine marketplace.
What interesting projects are you currently undertaking?
We are working with the Global Fund on the prevention of malaria, tuberculosis and HIV in Cameroon. We gather the data and provide it to them in real-time from the 2800 participating Cameroonian facilities. The Global Fund is then able to interact with the relevant stakeholders, such as the pharmaceutical companies, to produce a solution to combat these diseases.
For many years e-health faced strong opposition due to data protection and privacy regulations. What challenges is this sector encountering today?
We notice that 50 percent of the effort put into our technology portfolio is related to security and data protection. This is due to the fact that in each individual nation there are differing data protection laws and highly sophisticated Integrated Technology Processes (ITPs). Tiani Spirit is a specialist in each field, successfully exemplified all over Austria, where we provide complete access control for every patient and doctor. This means every e-health record is filtered against the country’s policies.
Our ability to perform was also shown during our masterpiece project; Smart Open Services for European Patient (epSOS). Tiani Spirit provided the main components for the e-health connectivity between all EU members taking part in the program.
How do you effectively engage the different government sectors of economics, health and justice?
Each entity wants to reuse our services in a similar way. There are two sides of the coin; from an industry perspective, every company wants to sell products over and over again, while from an economic point of view it makes sense to reuse infrastructure – hence – interoperability again is of paramount importance as many countries build up their systems in a proprietary way.
For example, the UK spent billions of dollars to connect around five percent of their systems with a very low outcome. We will soon begin undertaking work to provide the central component of the entire London healthcare system. 54 percent of all IT costs are related to interface development, so our approach is to always set up a strong IHE platform base. IHE ensures success by establishing a long-term, sustainable and economic network from the start by considering interoperability.
In Austria, a key to gaining recognition was to work closely with the government. How are you able to effectively enter foreign markets when this initial relationship is hard to come by?
When entering some markets, it was a big cultural shock. For example, in Japan there was a language and cultural barrier, but after some time we realized that we all possessed the international language of IHE.
The US is a more complex situation, though it is not due to failures of IHE. In fact, at the start the US had the correct theory in place investing 37 billion USD to adapt the system to connect all facets of healthcare. The issue was the industry pushed back in regard to standards; therefore, The Office of the National Coordinator for Health Information Technology (ONC) lowered the bar when it came to standards required, in-turn triggering a system in which companies were benefiting without providing a standardised information exchange.
Now, most of the state-wide electronic health information exchange systems are encountering economic problems as they were built in a proprietary manner, completely against the overarching theory of the IHE mythology. With the grapevine initiative, it allows us to attempt to recover struggling HIE’s in the US market. This helps us move the dial when it comes to achieving Tiani Spirit’s overriding objective of global interoperability.
Are you using partnerships as an entry tool?
Yes, we have used partnerships to enter markets. Cisco has been a long-term partner of ours and they are the leading global player in this sector, being present in every corner of the globe. Furthermore, we have founded subsidiaries in some nations to help from a sales perspective. We have a product that can adapt to any market and is easily scaled up or down depending on the requirements. The basic approach of Tiani Spirt is to make the process as easy and simple as possible so any hospital, or even GP office, can connect to a platform without any difficulties.
What are the next innovative steps for the company in expanding your IHE services?
Primarily, our current operations are based around document management, such as patient and result summaries. We are heavily working on a new component called clinical data repository; allowing discreet information, such as allergies or key figures, to be derived from documentation. This data can then be stored in a clinical data repository for public health, analytic and big data. For example, in Cameroon we measure HIV, tuberculosis and malaria. Using this technology, we extract the discreet data and report the analytics so organizations can use this information for future endeavors.
Tiani Spirit has put down the early building blocks for an Austrian Silicon Valley. What recommendations would you give to others looking to join the digital revolution?
The most difficult starting challenge for any young company is distribution, even if the technology is excellent. Therefore, they need a platform to sell, and this is another reason they should join grapevine. If a small team of people has the knowledge and innovative software available, grapevine will facilitate their growth.
Tiani Spirit was lucky enough to have Cisco on board, and now we are one of only a handful of companies on their global price list. This partnership has given us credibility when going abroad. Furthermore, Cisco, like us, has a global vision of ensuring interoperability, and in the future, we will be able to diversify our HIE technology into other sectors. Tiani Spirit is ready to be the catalyst to stimulate this technological revolution.