How 21st Century Cures and APIs could help EHRs behave more like a smartphone

What if EHRs offered the same functionality and ease of use as a smartphone, allowing users to add or remove various apps based on the needs of a hospital or a provider?

Two Boston-based bioinformatics researchers believe that will be the future of EHR interoperability thanks to a provision of the 21st Century Cures Act that requires health IT products to have application programming interfaces (APIs)—an advancement that could change the dynamic between hospitals, IT vendors and researchers.

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In a perspective published in the New England Journal of Medicine, health informatics researchers at Harvard Medical School and Boston Children’s Hospital wrote that APIs could replace interoperability with "substitutability" by allowing a broad range of apps to interact any EHR system.

Experts have previously underscored the importance of standardizing APIs. Although 21st Century Cures doesn't include specific API standards, the authors pointed to several that are already used within the industry and could gain a stronger foothold with additional regulation.

Unlike Meaningful Use regulations where hospitals and providers have been “largely passive participants,” open API regulations would give hospitals more power to demand functionality from IT vendors. Meanwhile, researchers would have broader access to real-world data generated through specific apps.

“A uniform, open, standardized health care API would allow a given app to run on any EHR,” they wrote. “This approach would produce game-changing economies of scale and starkly contrast with current conditions, in which nearly all innovative applications require expensive, time-consuming, custom integrations to connect to EHRs.”

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Researchers and providers have been eager to use APIs to improve IT systems and support new care models. So far, small health companies have found it difficult to access API data from EHR vendors.