Why API’s are not Enough in Healthcare
Lately, I’ve been reading a lot of articles that stress the importance of open APIs in healthcare organizations, and that most EHR’s don’t have the necessary APIs for integration. I agree that APIs are absolutely needed in healthcare, but I believe there’s a misconception that there aren’t any in practice. In my experience, APIs are prevalent in the industry. However, an API itself does not make interoperability easy. In this post, I’ll go over the challenges associated with integrating APIs in healthcare and a solution that will assist healthcare organizations in achieving interoperability.
Challenge: Healthcare API Integration
Most hospitals and clinics already have an API (or several). The challenge with integrating healthcare organizations is that they are just that – separate organizations. Each organization provides a healthcare service, but they provide that service using their own process. Because they are large organizations, they have the means and capability to customize the software to suit their process, rather than adjusting their process to suit the software. The end result is that the software installed (even if it comes from the same vendor) is configured differently at each organization. Also, the software is continuously evolving as local requirements and influences are addressed by the hospital administration.
For example, consider the admission process for a patient at three different hospitals: A, B, and C. The information that is used to identify a patient record is mostly the same, but it’s entirely possible that hospital B and C’s EHR stores the information differently than hospital A (i.e. Hospital B might not require the patient’s maiden name.).
Now, consider the possibility of a new Ebola outbreak, similar to the one that took place in 2014. Hospital A has a field for this outbreak already, labeled “Ebola”, so they don’t have to change anything in their EHR. Hospital B decides to use the maiden name field if they suspect a patient could have Ebola and so they enter the word “Ebola” in that field. Hospital C decides to create a new language called “Ebola” and they add that as an additional language that the patient can speak. At each hospital, the staff knows where to look, and what the new values mean.
In each case, the APIs that these systems use to communicate will all still work, but the semantics or meaning of these fields has changed. So when you’re dealing with APIs, it’s not enough just to have the API. You need to understand what the API is providing you, and how that relates to the other information that you’re working with. Both of the examples above illustrate how and why hospital information systems evolve over time.
Solution: Interface Engine
So how do you fix the problem of integrating an API in a healthcare setting? You use an Interface Engine.
An Interface Engine is a piece of software that sits between your application and the information system or EHR that you’re talking to. Mirth Connect is one of the better-known Interface Engines available. It acts like a giant translator that converts the information that you’re receiving into a format that you can understand and converts the data that you’re sending into the format that the receiving API can understand. Developing your application with this expectation in mind allows you to quickly integrate with systems because 98% of the data will match easily, and you can configure the system to translate the other 2%. This software will enable you to integrate efficiently with each organization that you work with.
To reiterate, I agree that APIs in healthcare are important. The industry is moving in that direction, but the complexity of connecting health systems together is far greater than most acknowledge. With advances like Interface Engines, the healthcare industry is on the right track to achieve seamless integration between healthcare systems and organizations, and conclusively, they’ll be able to improve the service that they provide to their patients.
Health Information System Integration
In this webinar we discuss interoperability in healthcare and answer attendee questions on Health Information System integration.