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Application program interfaces (APIs), code that allows two software programs to communicate with each other, have been around for years and quickly found their place in the enterprise.
"One of the reasons that restful interfaces and APIs have become so successful is because for the users, for the people going to Google, for the people going to UPS, stuff just works," Robert Havasy, executive director of Continua Health Alliance and vice president of Personal Health Connected Health Alliance, said at the HIT Summit in Boston.
And while the use cases for APIs in healthcare certainly exist, the industry is still sorting out this technology's place and purpose within the health IT space.
APIs in healthcare: Interoperability
Some experts assert that the answer to creating interoperability in healthcare is APIs.
"What an API can bring to the table is it removes some of that fragility of the method of communication, technically speaking, but it also helps to bring forth a standard that is native," Eric Rock, founder and CEO of Vivify Health, a company based in Plano, Texas, that offers a remote care management platform, said. "A native language to developers, software developers."
Rock explained that the native language APIs help create makes it easier to exchange data. Furthermore, APIs combined with standards like FHIR (Fast Healthcare Interoperability Resources), "could help to truly disrupt this market," Rock said.
Simon Lin, M.D., chief research information officer at Nationwide Children's Hospital in Columbus, Ohio, agrees that APIs in healthcare are an enabling factor to interoperability. However, APIs are not the complete answer to this issue, he said. In fact, APIs aren't necessarily the answer at all.
"[Interoperability is] not about the technology, it's more about the… value creation chain or the business model," Lin said. "I don't see a very clear business model for people to clearly gain or making money out of… [APIs] in healthcare easily."
Shafiq Rab, vice president and CIO at Hackensack University Medical Center in Hackensack, New Jersey, agrees with Lin: "Interoperability will not be created by APIs. They are created by cooperation and collaboration between different EHRs and everybody following the FHIR standard."
Rab explained that technologies other than APIs can be used to send and share data and that technology isn't the issue when it comes to interoperability.
"Other things can be used to send those data. Interoperability is a policy issue, it’s a standards issue, it’s a hard issue and it's an economic issue. It's not an API issue," Rab said. "That transport mechanism is done by standards [such as FHIR]."
Rab said that Hackensack is using APIs to exchange data as well as for billing and access to patient registration.
APIs in healthcare: Precision medicine
Lin believes that one very promising use case for APIs in healthcare is precision medicine.
"In particular, I really have a grand vision of making the genomic information available at your fingertips," he said. To achieve this, Lin said APIs are necessary.
"Think about a scenario when a patient is being prescribed with a particular drug. At this moment largely the choice of the drug would be determined by clinical history and then the rest is good luck," he said, adding that usually a physician will prescribe a drug, see how well the patient does taking that drug and then adjust medication accordingly. Lin calls this "a state of art."
But he believes that by having physicians know the genomic information of their patient up front and at the point of care, this trial and error process would be much faster and enable physicians to get the right drug to the right patient, at the right time.
"There are a lot of people who might be involved in this process who need to get access to this information and there are a lot of situations when you need it. So that's where really the API would play very well," Lin said. "That's a very natural fit of this information technology because APIs [are] really good at providing a very small piece of information to whoever needs it and whenever you need it right away."
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