Open APIs – What Holds Healthcare Back?
Sep 13, 2017 Thor Clark, Chief Technology Officer
Technologists entering the healthcare space with experience in other verticals can be in for some surprises. 3D ultrasound machines in the same room with pagers and whiteboards. Multi-million dollar software systems, installed on premises with few or no standardized interfaces for full two-way integration with other systems. Having entered the healthcare space with a background in enterprise software, the lack of standardized interface options is surprising.
Strong integration capabilities create real value. A clinician or other health care provider may at any moment need knowledge of lab results, information from a consulting physician, to inform food services of a change, to provide information to the primary care physician, to respond to a nurse call event, or literally hundreds of other events and data. What does it take to create and support such a system of action, and how as an industry can we improve?
A System of Action vs. System of Record
A System of Record requires that all available information is stored completely and accurately. A System of Action, on the other hand, requires that information and resources be readily available to inform or initiate action, with appropriate security and privacy constraints, and that records of action taken are stored completely and accurately. One critical requirement relates to “Open APIs”, an area where healthcare seems to lag. What holds healthcare back in this area, and what is changing? As capabilities change and advance, what should we prepare for? TigerText CEO Brad Brooks identifies Open APIs as a critical part of our opportunity to reduce toil: “With the rise of smartphones and an open API cloud-based communication platform, health systems can meaningfully reduce Toil and restore time for meaningful care to its physicians and nurses.” more…
Non-Healthcare Enterprise Software
Many software ecosystems support robust open API capabilities. These include support for authentication, data transfer, data updates, and more. Small vendors tend to make their APIs more generally available, and larger vendors tend to have processes in place to control access. These standard interfaces have made it simpler and more efficient to connect disparate systems and create value through integration. Engineers can relatively quickly implement valuable new capabilities spanning multiple systems. Numerous services provide connectivity solutions, ranging from prosumer and SMB focused solutions like IFTTT and Zapier to enterprise solutions including Mulesoft, Jitterbit, and Apigee. Even older technologies like XML/SOAP have widely available SDKs for most languages, and REST API capabilities are available in almost any relatively modern language.
Leading healthcare organizations are certainly aware of the benefits of standardized, open, and fully capable interfaces, and these organizations are full of intelligent, highly educated technologists and clinicians. Nevertheless, a small fraction of these capabilities are widely available in the modern healthcare system.
What constrains healthcare?
HIPAA and the truly sensitive nature of healthcare data constrain innovation in what are generally appropriate ways. It’s hard to argue that this is an artificial constraint.
Complexity of data
Because natural systems are the underlying source of much healthcare data, this constraint will likely never be resolved. Systems conceived of and built by people, for example financial markets, are qualitatively different from natural systems in terms of change in data complexity over time. New research and innovation in healthcare will create new datasets, new views of already collected data, new requirements around fidelity of data collection and storage, and new requirements around workflows, clinician engagement, and more. These changes are by their nature unpredictable and very dynamic. As a result, the effort involved in specifying and managing interface specifications over time is naturally higher.
Regional nature of HealthCare Organizations
An organization with 200 offices across the world is generally going to be more interested in standardized, cloud-enabled interfaces as compared to an organization with more employees all located in a single building. As health care organizations continue to grow, this constraint will continue to fall away and in some segments be more of a historical fact vs a current driver.
Lack of financial incentives
In other industries the availability of standardized interfaces and a willingness to integrate can be a key decision factor for purchases. In healthcare the government has made attempts to create similar financial incentives, but of course government incentives are more amenable to being gamed and as a result can have less impact than true market drivers.
What is happening now that supports the implementation of standardized, open, and fully capable APIs?
Increased acceptance of cloud services
Cloud services are becoming more acceptable, more secure, and more trusted. In other industries, Amazon Web Services has generally gone from a negative, to a neutral, to a positive over the past 7 years. Health care organizations in my experience are just moving into the ‘neutral’ category. Increased acceptance of cloud based services will be a positive driver for standardized interfaces.
Customer vision and expectations
CIO/CTOs and other health care leaders want standardized, open, and fully capable APIs. Leaders within organizations large and small understand the benefits for both patients and staff of improved connectivity and data transfer among systems.
Financial incentives are becoming more aligned around efficiency and outcomes. With a focus on outcomes and readmission rates, health care organizations see a clear connection between improved processes and financial benefits, and standardized interfaces make it cheaper, faster, and more reliable to build and support systems that measurably improve outcomes.
Benefits and Risks
Health care organizations and other members of the healthcare community have a significant and growing opportunity to improve patient satisfaction and patient safety, improve efficiencies, and meet targets.
TigerText operates at the leading edge of these trends, fulfilling our commitment to provide a clinical communication and collaboration platform connecting care providers to each other and to multiple disparate systems of record, in a single interface delivered via modern iOS, Android, and desktop clients.
To learn more about the benefits of the TigerText System of Action platform, and how we are leading and leveraging these API and integration trends, connect with us here.
Are you a software provider interested in working with TigerText on innovative solutions? Contact us here.