MedCity Influencers

Data democratization in healthcare – the API Way

Just like with the drive for Open Banking, Open Healthcare presents huge opportunities but a strategy and governance together with an open platform needs to be in place to gain trust with healthcare members to put the patient back at the center,

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One major complaint when it comes to Electronic Health Records and other health data is that wading through all the different portals and gatekeepers can feel insurmountable. Anyone who’s spent more than five minutes in a doctor’s office knows it is complicated, to say the least, to keep up with and track the required paperwork and outdated manual processes to get access to your personal information.

A recent Pew focus group study highlights these concerns and shows patients want access to more of their data. Patients want EHRs in their hands, they want better interoperability, and they want more innovative services.

They’re also frustrated that they need to personally carry their data from one healthcare provider to another, and sometimes even pay for it: they want more interoperability.

This goes way beyond data access — at the heart of it all is trust and choice. Healthcare customers need a democratic revolution when it comes to managing their information and a combination of business and technology innovation should be ready to respond.

Just as the living systems we are trying to keep healthy, healthcare providers need to go beyond just technology and structures but meet this challenge with new ways of behavior and communication

We don’t have to look too far to learn from failed attempts in this area. We can learn lessons from the UK NHS – National Patient Record Database – fiasco where Brain 1.0 thinking failed to rise to Tech 4.0 promise. It was a lack of mindset shift to consumption and data usage just as much as the management of the information – both converge on security.

The Open Everything Mindset – Innovate Safely and Securely with APIs

Without even realizing it, what patients are saying is they want healthcare providers to embrace APIs and open everything. People may have reservations about security and who gets access to what data, but when you tell them what APIs can do for them, they get the picture. More than half of all participants in the Pew focus groups selected “better care coordination for all patients” as the most compelling benefit to APIs in healthcare.

We have the technological power and we have the demand, so what is stopping wider adoption of APIs to unlock data by healthcare providers?

Government agencies have taken the obvious steps to improve data exchange from a regulatory standpoint by evaluating the right technology solutions, but now it’s up to the health care ecosystem to pick up where HHS and the ONC left off and address patients’ priorities through a culture and mindset of innovation driven by new ways of behavior and communication.

APIs are essential for the “omniexperience” – bringing it all to the patient when and how they need it – not the other way around.

The Department of Health and Human Services may have extended the compliance deadline for new interoperability rules in light of the Covid-19 pandemic, but the requirement to use standard APIs that would allow outside apps to connect with electronic health record systems is still coming up fast.

Rather than reactively complying, though, healthcare partners have a chance to proactively adopt an API-first model, which will give providers and patients the level of control over the information they desire.

In my experience with helping implement these goals, there’s a real opportunity to reimagine services from a patient-centric business perspective.

Putting patient choice and experience front and center with APIs – Here’s how:

  • API-First
    For API adoption to be truly effective, healthcare providers need to shift from approaching API delivery with a one-off provisioning focus to an API-First, APIs-as-Products culture. This requires executive sponsorship to drive a new mindset in which a common value proposition defined by both business product owners and technical product delivery managers informs full API lifecycle management with a Design First practice.
    The definition of the value proposition for APIs is a key best practice. This leads to design considerations around the data fidelity and granularity of the data returned by APIs that manage membership resources.
  • Open Platform Strategy
    World-class healthcare experiences powered by APIs require an open platform mindset in which capabilities take precedence over standalone applications being delivered and the integrations required to link them together becoming a “means to an end.”

These practices and a platform mindset can be adopted to bring business product owners together with technical delivery teams to shorten the delivery lifecycle for APIs and ensure that business KPIs can be tracked.

  • Data Ecosystem
    It’s one thing to say, “we need better access to our own health information” and quite another to put that information into patients’ hands in a usable way.

Most patients will likely need help understanding and making sense of the raw data contained in their records.

An organization’s data ecosystem strategy needs to dovetail with API strategy to make the great work of data scientists consumable for patients and provide the best choice for them.

  • Distributed Access/Central Governance
    The Pew study highlighted that patients overwhelmingly want access to their health information, but even more important, they want all their healthcare providers to be on the same page.

Using API Gateways in a hybrid environment is a reality – healthcare providers need to provide visibility and access for both cloud and on-premise with a single management plane to make sure the onus is not on developers to secure interfaces. Only with a plan and a platform for distributed governance can APIs allow better control over patient data instead of opening it up to security breaches and accidentally making it available to the wrong people.

  • Adoption of Standards
    Adoption of APIs can serve to drive standards – we need to look no further than the prevalence of FHIR which has been designed to be suited to resource management, not document management – exactly what is needed to give flexibility within a common framework for data sharing.

Just like with the drive for Open Banking, Open Healthcare presents huge opportunities but a strategy and governance together with an open platform needs to be in place to gain trust with healthcare members to put the patient, who often feels disenfranchised by an impenetrable healthcare system, back at the center, in control of their information, and ultimately their health.

Brian Otten is a Digital Catalyst at Axway, a hybrid integration software company that empowers customers around the world to compete and thrive in dynamic marketplaces by better connecting their people, systems, businesses and digital ecosystems. Brian has over 25 years of experience partnering with large enterprises in guiding strategy, adoption and execution of business technology transformation.

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