Catching FHIR: How Application Programing Interfaces (API) Are Breaking Down Patient Data Barriers

Apple. When you hear that word, do you think of the fruit that keeps the doctor away…or of the first company worth more than $1 trillion?

With over 700 million iPhones in use globally and 400 phones sold every minute, Apple is a relatable name to almost anyone. In fact, there is a popular YouTube video showing a 1-year old child successfully navigating an iPad, and then trying unsuccessfully to “swipe” a magazine page. How did a company that almost went bankrupt in 1997 become so relevant today?

Application Programming Interfaces

Innovation - Steve Jobs once said: “Innovation distinguishes between a leader and a follower.” Following the success of the iPod, Apple introduced the world to the touchscreen iPhone, establishing the company’s identity as an innovator. Apple continued to innovate by integrating different industries with its products through applications in the App Store. Most recently, Apple’s focus has been on advancing the health care industry by incorporating new application programming interfaces (APIs) for developers to work with.

For those new to APIs, imagine a fire hydrant. A fire hydrant limits how a fire truck can connect to a city’s water supply by regulating hose connection types. In a similar fashion, an API (hydrant) is a gatekeeper that sets guidelines on how a mobile application (fire truck) can interact with certain information stored on a device (water).

How is this related to health care?

Apple first began dabbling in health care with the introduction of HealthKit in 2014, which enabled users to download personal patient records from the Epic EHR. Then in 2015 and 2016, Apple released ResearchKit and CareKit respectively, improving data collection for researchers and enabling developers to create apps for day-to-day care. All three of these “kits” include APIs that expand a developer’s ability to work with patient information. In a bold move, Apple most recently introduced the new Health Records API.

Why is this new Health Records API a major milestone?

Before highlighting the benefits, it’s important to understand what this API targets. Over the past decade, one of the biggest changes to health care in the U.S. was the American Recovery and Reinvestment Act, which required all health care providers to adopt and use some form of electronic medical records (EMR) by January 1, 2014. As one can imagine, out of this mandate arose a myriad of competing EMR and EHR (electronic health record) systems - two of the largest and most recognizable being Epic and Cerner. With the countless number of EMR/EHR systems, cross coverage of patient information can be a nightmare. To mitigate some of the compatibility issues, an organization called HL7 was formed to create standards for compatibility across different platforms. The latest standard created by HL7 for transferring health care information between systems is called FHIR. Despite this FHIR standard, the problem of a comprehensive patient record remained.

Apple’s latest Health Records API seeks to alleviate some issues with sharing patient information. The API enables users to download personal patient data onto their phones using the FHIR standard. The impact of this API is significant due to numerous partnerships that Apple established with hospital and health care systems. In January 2018, Apple began a pilot program with 12 hospitals including prominent names such as Johns Hopkins Medicine, Cedars-Sinai, Penn Medicine, Rush University Medical Center, and Cerner Healthe Clinic. To date, Apple has increased that number to over 80 participating hospitals.

As the list grows, so does the ability for patients to download and aggregate patient information on their phones. The benefits of providing a central node of information begin with empowering patients to understand and ask more questions about the care they are receiving. Using the API has other benefits - a patient on vacation is admitted to the ER because she has trouble breathing. Having no way to immediately access the patient record residing within her regular care network, an ER doctor would have to rely on intuition and experience to treat the symptoms. With the new Health Records API providing access to EHR systems, the patient could instead open an app on the phone and show the doctor any record of asthma, allergies, and medication that is pulled from her care network - and that right there could drastically improve her treatment!

Similar to Apple, pMD is focused on building innovative products that improve patient care and save lives. As new ways to manage patient information emerge, pMD will remain dedicated to keeping up-to-date with and leveraging the latest technology.

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, care navigation, and clinically integrated network software and services, please contact pMD.

To find out more about pMD's suite of products, which includes our charge capture and MIPS registry, billing services, telehealth, and secure communication software and services, please contact pMD.

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