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Cheat Sheet

Application Programming Interfaces (APIs)

5 Minute Read

Key Takeaways
  • APIs are tools that enable discrete data to be securely and efficiently shared between systems with incompatible standards and specifications. They are cheaper, faster, and more flexible than traditional methods of data sharing.
  • They are not widely adopted in health care today but have been gaining recent traction because of requirements in the 21st Century Cures act, proliferation of EHRs, improvements to API technology, and demand for a seamless and digital-first patient experience.
  • APIs enable seamless data exchange and have the potential to benefit stakeholders across the industry, including health systems and hospitals, developers and digital health vendors, and patients.
 

What is it?

Application programming interfaces (APIs) are standardized communication protocols used to share data across systems. They can be thought of as “data messengers”—tools used to send and receive discrete pieces of information between systems that have unique and incompatible standards and formats.

APIs are not new, and they facilitate most of the digital interactions consumers experience in other industries. APIs are used to share information in a consistent format across different email platforms like Outlook and Gmail. Each platform has distinct characteristics and settings, but the emails and calendar invites flow seamlessly between platforms because of APIs. Online travel shopping sites like Google Flights or Expedia use APIs to pull flight information from each airline’s database and consolidate it in a single user interface.

APIs are less common in health care than many other industries. But interest has risen sharply in the past few years as EHRs (1) have become increasingly widespread and regulations like the 21st Century Cures Act actively promote and mandate their adoption. Other factors like consumer demand for a streamlined, digital-first experience and fundamental improvements to API technology and related standards have also contributed to their growth.

Today, most health care organizations rely on a complex and diverse array of systems to collect and exchange data, including EHRs, CRM (Customer relationship management) systems, billing and scheduling tools, remote monitoring devices, and even fax machines. APIs can be used to bridge communication across these tools in a faster, better, and cheaper way than traditional data exchange processes.

 

Why does it matter?

APIs bring a new level of flexibility and reduce technical complexity in the health care technology landscape. They provide a secure and efficient path to speed the flow of data to and from patients and partners. APIs can benefit many stakeholders, including health systems and hospitals, developers, and patients. 

Health systems and hospitals

No one vendor can address the diverse requirements of health system stakeholders in one single platform. APIs let IT solutions interact seamlessly so health systems can bring in “best of breed” partners to fill functional gaps and perceived weak spots in their primary vendors’ solutions. APIs can also help health systems fill data gaps. Many patients have data living across multiple EHRs, apps, and devices. APIs allow providers to integrate different data sources and deliver more precise and coordinated care.

Developers

APIs make it easier for health IT developers, both vendors and IT departments within health systems, to access the data they need to build new applications. They can speed innovation by shrinking the software development timeline and accelerating implementation cycles. They also provide flexible integrations, built-in security, and can save data storage space.

Patients

As health systems increasingly adopt APIs, patients will be able to move freely between care sites and their complete data will go with them. Patients will benefit from greater choice and better coordinated and data-informed care. In the future, patients will also have access to useful apps that leverage their personalized health data. APIs could enable a true internet of things experience for patients by linking data from multiple devices and apps to a singular medical record.

 

How does it work?

At their core, APIs are a set of technical instructions for how two systems should interact with each other. A third-party application and an EHR can use an API to send and receive data in a compatible format, without ever needing to understand the unique technical specifications and standards of the other system. APIs can facilitate this kind of push or pull exchange of information between any devices or systems.

How APIs enable data exchange

In health care, most APIs are built and supplied by vendors that operate under a “data-as-a-service” business model. These vendors serve as the intermediary between any organization that has rights to data and is a “data holder”, including payers, providers, and the government, and developers who want access to data to build an application. Many health systems have internal IT teams building applications and could be a data holder or a developer depending on the context.

APIs are designed from the ground up for ease of use by developers. When a developer is ready to deploy an API-enabled application, the application requests access to the specific data it needs, and upon approval it can access the required data securely without waiting for custom file exchanges or messaging interfaces to be negotiated and configured.

 
Conversations you should be Having
  1. Establish a lightweight application governance process. APIs make it easier, cheaper, and faster to integrate specialized capabilities into a system. Having a complementary lightweight decision process will further speed the overall time to value.

  2. Evaluate whether your vendors’ security model is sufficiently detailed. APIs have the potential to deliver better security than legacy integration approaches, but they require a nuanced approach to information access control and provisioning.

  3. Assess any training or hiring needs on your IT team. Configuring and using APIs will require different tools and skillsets than former messaging and file-based integrations. IT teams will likely need to manage multiple APIs connected to different services.

Abiding by changing regulatory standards and upholding patient privacy should remain top priorities for any organization pursuing APIs. APIs have the potential to deliver better security than legacy approaches, but standards for access control and provisioning are still evolving. Decisions to share, receive, and use health care data through APIs should be continuously evaluated in the context of HIPAA requirements.

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Sources

Solis, Jeff, “How APIs Will Solve Many of the Interoperability Challenges in Healthcare Data Exchange,” HIMSS, March 4, 2020, https://www.himssconference.org/updates/how-apis-will-solve-many-interoperability-challenges-healthcare-data-exchange; Murphy, Brian “Open APIs in Healthcare: The Future of Data Integration Webinar,” Chilmark Research, August 20, 2020, https://www.chilmarkresearch.com/open-apis-in-healthcare-the-future-of-data-integration-webinar/; “APIs in healthcare: a guide for physicians,” Mobius MD, September 9 2019, https://www.mobius.md/blog/2019/09/apis-in-healthcare-a-guide-for-physicians/; Advisory Board, “APIs and the App Ecosystem”; Advisory Board interviews and analysis.

Siwicki, Bill, “What you need to know about healthcare APIs and interoperability,” Healthcare IT News, April 11, 2019, https://www.healthcareitnews.com/news/what-you-need-know-about-healthcare-apis-and-interoperability; Advisory Board, “APIs and the App Ecosystem”; Advisory Board interviews and analysis.

“About APIs,” The Office of the National Coordinator for Health Information Technology, https://www.healthit.gov/api-education-module/story_content/external_files/hhs_transcript_module.pdf; Murphy, Brian “Open APIs in Healthcare: The Future of Data Integration Webinar,” Chilmark Research, August 20, 2020, https://www.chilmarkresearch.com/open-apis-in-healthcare-the-future-of-data-integration-webinar/; Advisory Board, “APIs and the App Ecosystem”; Advisory Board interviews and analysis.

Source: Solis, Jeff, “How APIs Will Solve Many of the Interoperability Challenges in Healthcare Data Exchange,” HIMSS, March 4, 2020, https://www.himssconference.org/updates/how-apis-will-solve-many-interoperability-challenges-healthcare-data-exchange; Advisory Board, “APIs and the App Ecosystem”; Advisory Board interviews and analysis.

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