There was a time when the healthcare industry largely relied on phone calls and fax machines to establish interoperability within the system. Health records would exist in different versions in different places and often critical health data would be too scattered to give a clear picture of a patient’s health. Then came a time when the concept of value-based care began taking root and the importance of having data in one place in an easy-to-access format made tremendous sense rather than collecting it from a multitude of data silos.
The healthcare industry was now waking up to healthcare analytics, interoperability, and the importance of APIs. Across a forever-expanding healthcare landscape, application programming interfaces (APIs) gave organizations the opportunity to streamline and share data for meaningful exchanges between systems.
APIs allow systems to communicate and depending on how they are configured they can do a lot more. They can send data, retrieve data, or even update individual health records as and when required. The ability of a healthcare facility to determine the coverage a patient is entitled to for a particular procedure after feeding information about the patient into their system that is linked to insurance companies is a classic example of how empowering APIs can be.
Interoperability lies at the core of APIs and demonstrates how critical coordinated care is for the healthcare industry. Understanding a patient’s journey is important to ensure they are on the road to recovery quickly and effectively. The fractured details of a patient’s clinical story however often pose a big challenge. For instance, it is important to know if a patient after leaving a facility following a surgery signed up for a remote monitoring program or was taken care of at home with the health of a home health agency. These are the finer things that add up to create the bigger picture.
APIs are a booming market and the healthcare API market is expected to grow at a CAGR of 8.72% in the forecast period 2021 – 2028 accounting for USD 440.76 million by 20281. APIs are creating dynamic digital ecosystems to help the healthcare industry attain operational excellence and improve customer experiences. APIs are clearly setting the stage for successful treatments and recovery ensuring interoperability every step of the way.
The role of APIs in the evolving healthcare landscape
The proliferation of smart wearable devices and wellbeing apps is further iterating the role of APIs in the digitally advanced health and wellness industry of today. The global wearables market grew 27.2% year over year in the fourth quarter of 2020 and the shipments of wearable devices globally have now touched 153.5 million2.
The pandemic has further accelerated the need for a better lifestyle and wider access to healthcare. The US Centres for Medicare and Medicaid Services are largely relying on APIs to bridge the gap between patients and healthcare. In fact, both healthcare organizations and payers need to use APIs – particularly the Fast Healthcare Interoperability Resources (FIHR) standards to attain optimum interoperability.
Explains Jay Bercher, deputy program manager at Solutions By Design II, “It goes without saying that APIs have closed the gap in many ways on how information is sent, retrieved, and processed. However, some technological gaps have appeared. As there is a lack of data standards in the industry and multiple technologies, APIs must be created custom to the needs of the service it is providing for each system.”
Technologies such as Artificial Intelligence (AI) are also key drivers. AI is facilitating the conversion of patient information into crucial diagnostic information to help detect conditions early on. Today, data sharing with correlations is helping in a big way. Just to iterate this, if 500 people are buying medicines for cough and cold using their credit cards in a particular area around the same time, it indicates the possibility of an outbreak in that particular area.
Different instances and scenarios highlight the importance of data and data sharing. APIs are increasingly being used to conduct wellness programs using cloud-based solutions to promote healthy lifestyles, offer behavioral change capabilities, and set fitness goals to stay on the wellness track.
As wearables and the Internet of Things (IoT) become mainstream, APIs enable the swift transfer of data for users to review and act upon. Data from third-party accounts is also gathered to enable a more integrated approach towards healthcare.
Ensuring interoperability in the healthcare ecosystem
The implementation of FHIR (Fast Healthcare Interoperability Resources) in healthcare systems for electronic data exchange will make sharing and accessing healthcare data faster. They prepare both the healthcare payer and the provider systems to afford greater access for patients to their own healthcare information by defining a standard minimum of data that must be made available.
As Health IT system developers implement the interoperability standards, they must shift the focus to meet their immediate interface requirements to conform to interoperability standards. The FHIR specification provides a roadmap to interoperable data exchange. This ensures that the adherence to this specification means all of the supported system interactions will work with other systems claiming conformance to the same standard.
The challenges and barriers to API adoption
Despite all the attention that APIs get and with nearly 90% of healthcare stakeholders considering APIs to be mission-critical for business strategies as per a study3,
- Only 24% are actually using them at scale
- 67% of providers, 61% of payers, and 51% of healthcare tech vendors expect to use APIs at scale in 3 years
Providers participating in the study were more concerned about security (52%) and cost (47%) while payers had other concerns such as technical infrastructure (45%), privacy (43%), and lack of industry standards (43%). The learning curve is steep and calls for specialized skill sets to create or use APIs and address the challenges in adopting them. Patients need to understand the role of APIs too and standardization methods need to be employed to ensure efficient use of APIs.
Ben Moscovitch, project director of health information technology at Pew Charitable Trusts points out, “Increased use of APIs—particularly those based on common adopted and consistently deployed standards—has the potential to make healthcare more efficient, lead to better care coordination, and give providers and patients additional tools to access information and ensure high-quality, efficient, safe, and value-based care. Yet obstacles remain, such as some hospital hesitation to grant patient access to data, lack of bidirectional data exchange, confusion around the process of implementing APIs, and potentially prohibitive fee structures.”
Some of the most common challenges include:
- Data security – Providers are responsible for the security of patient data, and the absence of security measures or compliance checks can lead to vulnerabilities.
- Data complexity – The healthcare system is huge and complex with patient data spread across several databases. A longitudinal health record of patients is necessary to ensure proper care delivery.
- Data authority – Sometimes, a single patient may have two different medical records citing opposite or different medical conditions. This can be frustrating as physicians will be unable to determine which one is more accurate or updated.
Seamless bi-directional data interoperability is what everyone is working on. Once we figure out a way to navigate APIs in healthcare, hospitals, clinics, and facilities will discover more use cases to leverage the value of APIs. Those who have realized its potential are already leveraging tools for designing, testing, and monitoring APIs for seamless integration and interoperability across the ecosystem.
API is the backbone that is necessary to create efficient ecosystems that can support seamless data capture and exchange for an integrated value chain. If the data is clear and accurate, stakeholders will be able to connect the dots more efficiently.
Trust Trigent for a successful API implementation
Trigent with its domain knowledge and technology expertise helps stakeholders across the healthcare continuum drive innovation and scale to meet enterprise requirements. We offer tools and solutions for the effective implementation of APIs and help you monitor them throughout the API cycle.
Our integration solutions have been helping healthcare providers and healthcare-related professionals leverage patient data successfully for better health management. We can help you too.