The inquiry is timely, given the widespread frustration providers have with health information technology (HIT), and electronic health records (EHR) systems in particular. This frustration stems from many HIT/EHR systems are locked in proprietary systems. This hinders technology’s ability to connect and exchange information freely between disparate systems, devices and sensors along the care continuum, thus undermining the overall goal of using HIT to improve efficiencies and reduce costs.
An example illustrates the point. Because HIT systems don’t work together, most hospitals use nurses to manually double check input from disparate “smart” devices. For instance, an infusion pump reports the level of pain medication being administered to a patient, as does the EHR. But these numbers sometimes don’t match, and must be double checked by at least two nurses to confirm the right dosing. Not only is this a step back for efficiency, but it’s also another manual process that has the potential to create errors and patient safety issues.
There are also economic consequences of data fragmentation. According to the Office of the National Coordinator (ONC), U.S. providers are spending $8 billion a year due to the lack of interoperability.
To address this problem and reduce the unnecessary fragmentation of healthcare data, it’s time to require the use of open and secure applications programming interfaces (APIs).
In April, a group of America’s leading scientists, named JASON, published a report that found the current lack of interoperability among HIT data sources is a major impediment to the exchange of health information. They recommended that EHR vendors be required to develop and implement APIs that support health data architecture. The recommendation was also endorsed by the President’s Council of Advisors on Science and Technology (PCAST) in May. Requiring open APIs as a foundational standard for healthcare data would reverse the current legacy of locked systems and enable the real-time exchange of information in EHR systems to reduce costs and improve patient safety.
While it would be preferable for the market to respond to these challenges and voluntarily open APIs based on the needs of providers, it’s essential that we move as quickly as possible. To achieve the fastest momentum, it may be necessary for the ONC to lead, through government action, by requiring open API data elements in EHRs to meet meaningful use.
A recent Health Affairs article noted that today’s HIT systems operate less like ATM cards, allowing providers to access patient information anytime, anywhere, and more like frequent flyer club cards designed to preserve brand loyalty. It’s time to change that dynamic with open APIs. Without it, we will never unlock the true potential of HIT.
Keith Figlioli is senior vice president of Healthcare Informatics and a member of the ONC Standards Committee