Product Update: 2023 Mid Year Check-in

At the beginning of the year, the Canvas Product Team set our 2 Year Product Strategy:

Canvas enables the disruptive tech enabled healthcare provider to deliver the best care suited to meet the needs of their patients. The Canvas platform empowers these customers to deliver differentiated care models by supplying the building blocks of care modeling in abstractions, experiences, and tools that developers can build upon without having to worry about basic functionality or interoperability while having trust, safety and reliability built in. By building the whole practice components of an EMR as libraries, SDKs and APIs, external developers are able to rapidly iterate on and customize care models in collaboration with their clinical counterparts.

Now, seven months into 2023, we wanted to reflect on the year so far and share some updates on what we have planned for the second half of the year. 

Reflection on the first half of the year

In March, we decided that in order to better support our customers in their care modeling journeys, we first needed to address the variability in end user experience and performance. Using Maslow’s hierarchy of needs as a prioritization tool, we decided to focus on making sure the most basic needs of our customers were met before advancing up the pyramid to the differentiators that will further set our product apart. We shifted resources, interrupted our regular planning cycle, and invested in growing our team to address this need. In doing so, we were able to make significant strides. Some key targeted changes, including how the patient timeline loads and renders, as well as some front end changes, resulted in tangible improvements that were shown both through our own monitoring and analytics, as well as feedback from end users. With the worst of the pain behind us, we are now in a much better position to allocate more attention to advancing the platform.

Even with this redirected focus, we were still able to make solid progress moving Canvas forward. During the first half of the year we released many new features (permissions, multi-provider scheduling, other non-clinical events, questionnaire carry forward), tackled key defects, and laid the groundwork for large architectural changes planned in the second half of the year. To stay up to date on what is released each week, make sure to subscribe to our release notes. 

What’s next

Performance

Performance of the application will continue to be of paramount importance and focus for us.  We will continue to take an aggressive stance to improve responsiveness of the application. Through the re-architecture of the commands framework, the Commands SDK work noted below, we will improve the most important use case for Canvas, patient charting. By reimplementing Commands, we will reduce UI latency within charting, where application responsiveness matters the most - when clinicians are engaged with patients. In addition, we will continue to improve general application performance through targeted refactoring and simplification of how UI components render. 

Reliability

We know that our application is mission critical for our customers and that bugs and defects disrupt users’ experience, adding unnecessary frustration to their day. Our customers’ input is incorporated into our prioritization process to ensure that we are addressing issues that have the greatest impact. We will continue to incrementally address bugs and defects sprint by sprint. 

Commands SDK

We have begun the exciting journey of migrating our existing commands into a new framework called Commands SDK. Up front, this offers end-user benefits including improved performance and consistent user experience across Commands. Longer term it also sets the stage for a critical element of customizability in Canvas: the ability to customize or create net new Commands. We see this as a necessary component for care modeling. Clinicians take 90% of their actions through commands. Therefore the ability to customize Commands allows our customers to customize 90% of workflows, tailoring them precisely to their care model. 

Plugins

Over the past few months, we built out the infrastructure for plugins. Plugins are full-fledged python packages that customers can write and upload to their Canvas instance. They represent the next generation of our SDK. With a simple event-based structure, they allow customers to respond to user actions or data changes in the system to automate workflows or customize the user interface. Some of the early use cases include customizing search functions in Canvas (like condition search in a Diagnose Command, or medication search in a Prescribe Command), customizing print templates, or responding to status updates on prescriptions or lab orders to ensure errors don’t fall through the cracks. To learn more about how to think about Plugins, click here. Currently, Plugins are still in beta.

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Expanding our API

We continue to invest in our FHIR API, expanding the capabilities for our customers to control their workflows across multiple tools beyond just Canvas. Currently we are developing write endpoints for Conditions, Allergies, Medication, and Immunizations. Once complete we will shift our attention to reading and writing clinical and administrative documents via the API. We also have plans to further develop our Claim endpoint to better support our billing partner integrations. 

Scheduling: Availability within Canvas

We are building the models to support a more integrated provider availability and appointment scheduling workflow. We will continue to support having gCal supply the availability information through a push mechanism (rather than the pull mechanism used today) while also allowing our customers to set availability directly in Canvas. As part of the effort, we will be unifying the user experience despite availability being provided by two different alternative methods. These enhancements will lead to improved performance and it will also open up future use cases in 2024 to build additional scheduling logic that better support different Care Models.

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Migrating Settings

Canvas is designed to enable our customers to iterate on their care model as their business grows and changes. To better support this, our goal is to make copying development work and configuration between environments as easy as possible. We will begin extending our tooling to allow builders to create and test new workflows in a dev or staging environment, with the ability to migrate these new workflows to production when ready. 

Regulatory Requirements

B10 (EHI Export): Once the ONC Final Rule regulating the 21st Century Cures Act rule is fully in effect at the end of 2023, the EHR base definition will expand to include § 170.315 (b)(10) Electronic Health Information export. This addition requires certified EHR systems to provide computable copies of electronic protected health information (EHI) for either an individual or a group of patients. The data set will need to encompass the entire clinical record (essentially the “designated record set” that individuals are entitled to under HIPAA’s right of access). Canvas’s extensive read capabilities within our FHIR API put us in a good position to meet this requirement; however some additions are necessary.  Our API roadmap noted above includes the necessary additions to meet this requirement. 

Prescribing: The DEA recently extended the COVID-19 Telemedicine Flexibilities for Prescribing Controlled Medications to November 11, 2023, allowing prescribers to prescribe controlled substances across state lines until that date. Canvas will enable our customers to meet the requirements for these regulatory changes by updating our prescribing workflow to ensure that the proper state information is included.

Join us for our upcoming product webinar

The Canvas Product Team will be hosting a webinar on Thursday, July 27th at 4 PM ET/ 1 PM PT to answer questions and capture feedback. Click here to register. We’d love to hear from you to make sure the direction laid out above aligns with your organization and your care modeling journey. 

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