- Healthcare app interoperability is not a new challenge for healthcare organizations. Over the past several years organizations have had trouble connecting their health IT tools to their EHRs. The increased use of application programming interfaces (APIs) is key.
Large provider organizations can be tasked with integrating hundreds of healthcare applications, which can take months. These apps need to not only work seamlessly with other applications, but also be HIPAA compliant.
For example, an organization may purchase a tool for monitoring diabetes. To integrate that monitoring tool, a new project for the IT department would need to take place so the app will connect with the EHR and any other tools it will need to share data with.
Finding an API that works with existing applications and can connect new applications without the IT department needing to dedicate as many resources to it can help organizations have an easier time integrating their applications.
Interoperability challenges can be traced back to the initial introduction of applications and other digital tools into health IT infrastructure, according to Redox Senior Developer Nick Hatt.
“The biggest challenge is this bottleneck problem,” Hatt explained to HITInfrastructure.com. “Through the 1990s and into the early 2000s health systems typically bought the best of breed off-the-shelf solutions.”
Organizations that needed a lab system or a scheduling system would go and buy the best of those individual solutions based on reputation and user base.
In recent years, this way of approaching health IT solutions has changed to a more integrated approach. Epic EHR, for example, made scheduling, lab, claims, and other applications available through one vendor. This evolved strategy is becoming outdated as organizations are adding a new surge of advanced tools like telehealth and wearables. There is a demand to connect these new tools to the EHR.
Most health systems have been operating on the assumption that the number of connections will decrease, according to Hatt. However, health systems have these products that need to be integrated and are now understaffed.
“An integration engineer or interface analyst is needed to perform these types of connections,” Hatt explained. “They have a specific knowledge of HL7, and their first priority is to maintain all the existing connections, so they can start to add new things. But the complexity keeps growing exponentially when new things are added to the mix. There's this high demand for new integration and not enough people at the health system to integrate everything.”
Most health IT infrastructure systems already have some form of integration solution because they can’t function without integration of some kind in place. The challenge organizations are facing now is how do they modernize their IT architecture enough where they can scale out connections and modify applications quickly.
“The real problem right now is this transition phase where it's an old kind of infrastructure that worked well for 30 years but now government incentives are pushing people towards web-based APIs, and newer applications are just out of the loop when it comes to the old variety. They’re disconnected.”
Legacy solutions are a notorious roadblock for many health IT infrastructure projects and often cause interoperability and security problems.
“Security was never really built into some of these older connections, so it was always sort of assumed that it would run within the healthcare network,” said Hatt. “Things going outside the system firewall has never really been easy. But a lot of these new solutions are cloud based so they have to bridge that gap.”
These challenges are where APIs become even more critical to integrating health IT systems. An API is an interface that allows unrelated software programs to communicate with one another. They act as bridges between applications, allowing data to flow regardless of how each application was originally designed.
According to Hatt, APIs are often the missing piece of health IT infrastructure.
“If you think about data sharing as a public utility, like water or electricity, the healthcare industry looks like a street,” Hatt explained. “Each house is a different health system.”
“In the utility world, you need to have that last mile of electricity or plumbing coming to your house,” he continued. “In healthcare that just doesn't exist for sharing data. Even identifying where you would go to use an API for one of those health systems is impossible without getting into a whole long IT implementation process.”
Organizations should seriously consider an API solution to help integrate different health IT systems.
“APIs help organizations form a transition path from needing to take each project on one at a time to the point where they can just stand up a portal or an API information page where other organizations can come and figure out how to connect, rather than being told how to connect their products,” Hatt said.
“Some EHR vendors are starting to dip their toes into that kind of interoperability and doing things like integrating FHIR into the business part of their software,” he added.
As organizations continue to add digital health IT tools to their IT infrastructure interoperability needs to be a high priority. Tools that don’t work together can halt clinician workflow by making it difficult to retrieve information. Consulting different API options can make it easier to securely exchange data within and outside of a health system.