A new research report has taken the not-so-radical position that greater use of APIs to extract and share health data could dramatically improve interoperability. It doesn’t account for the massive business obstacles that still prevent this from happening, though.
The report, which was released by The Pew Charitable Trusts, notes that both the federal government and the private sector are both favoring the development of APIs for health data sharing.
It notes that while the federal government is working to expand the use of open APIs for health data exchange, the private sector has focused on refining existing standards in developing new applications that enhance EHR capabilities.
EHR vendors, for their part, have begun to allow third-party application developers to access to systems using APIs, with some also offering supports such as testing tools and documentation.
While these efforts are worthwhile, it will take more to wrest the most benefit from API-based data sharing, the report suggests. Its recommendations for doing so include:
- Making all relevant data available via these APIs, not just CCDs
- Seeing to it that information already coded in health data system stays in that form during data exchange (rather than being transformed into less digestible formats such as PDFs)
- Standardizing data elements in the health record by using existing terminologies and developing new ones where codes don’t exist
- Offering access to a patient’s full health record across their lifetime, and holding it in all relevant systems so patients with chronic illnesses and care providers have complete histories of their condition(s)
Of course, some of these steps would be easier to implement than others. For example, while providing a longitudinal patient record would be a great thing, there are major barriers to doing so, including but not limited to inter-provider politics and competition for market share.
Another issue is the need to pick appropriate standards and convince all parties involved to use them. Even a forerunner like FHIR is not yet universally accepted, nor is it completely mature.
The truth is that no matter how you slice it, interoperability efforts have hit the wall. While hospitals, payers, and clinicians pretty much know what needs to happen, their interests don’t converge enough to make interoperability practical as of yet.
While I’m all for organizations like the Pew folks taking a shot at figuring interoperability out, I don’t think we’re likely to get anywhere until we find a way to synchronize everyone’s interests. And good luck with that.