The Role of Open API’s in Healthcare Interoperability

All great comments and insight David Boerner. I agree that API's can play a major role in reducing or even eliminating the quest for "interoperability". Many in healthcare agree that what API's can efficiently deliver - most of the critical elements of a patient's story - is much more useful than a cumbersome, expensive, well-mapped, point-to-point information that experts would call truly "interoperable".

Thanks for the post, David. I can offer some examples of how an Open API is being used by Intelligent InSites to connect real-time (RTLS) operational data with location sensing technology, asset management systems, paging systems, EMRs, etc. Full disclosure: I'm in communications, not engineering. I'm happy to loop in key experts on our tech teams for "under the hood" info. InSites makes software and mobile apps that visualizes RTLS data that's flowing through most health systems. (If you're familiar with Quantified Self, you can think of this as "Quantified Healthcare" or "Quantified Ops" in that having objective, automatically collected visibility into operations is a must to drive the kinds of strategic operational transformation that's needed to meet demand while lowering costs.) That data and visibility automates patient flows, populates view boards to inform coordinated care teams, and provides analysis on equipment and exam room utilization, cycle times, etc. The InSites technology platform was built from the outset to be open and extensible via an open RESTful API. Using the open API, we have built bi-directional integrations to many HIT systems, like active and passive RTLS systems, (like CenTrak, Sonitor, Cisco MSE, WaveMark), paging systems like Rauland Borg, WestCom, Vocera, EMRs (Epic, Meditech), and a variety of other clinical and building systems including Engauge, Censitrak, Picis, Four Rivers. Just a sampling to give you an idea. Standard interfaces include SMS, TAP, HL7 ADT, HL7 RTLS, XML, etc. These integrations are done to add value on both ends--with real-time location data informing applicable screens and functions in the EMR (as an example) and vice versa. From a health system standpoint, this ability to interconnect enables things like the 50+ use cases automating processes at Wake Forest Baptist Health, driven by their SPOT (Service Excellence Patient Safety and Satisfaction) initiative out of the Office of Enterprise Visibility. Just a few examples where InSites RTLS data is enhancing systems/processes at Wake Forest: temp monitoring, wait-time management, infection control, milestones of care. They are measuring hard and soft dollar savings, and it's in the millions just under 3 years in. [I'll stop there to avoid crossing the line into marketing-speak.] We're using our open API in all implementations and the use cases and integration opportunities continue to grow rapidly. We're seeing this is a "must-have" capability in all inquiries.

Welcome to the world of the URL. Basically, all of these new API systems are using REST, including DICOMweb for those asking about Radiology. This is not a new concept to the industry, as standards such as DICOM WADO have been around for long time. Two of the biggest challenges I am dealing with today are adoption and quality of service. Open API's are great if everyone adopts them, however there are still many solutions on the market that refuse to innovate, which can hold back healthcare providers from utilizing these new Standards. One other big issue is that no one is holding any vendor to a benchmark because there is no benchmark for API service performance in this industry. Great article, just wanted to share my experience, as we still have a lot of work to do in the industry to bring up the quality and availability.

Million dollar question: Who's actually doing this in healthcare, even in Radiology?

An open API works best, if the standard of connectivity is followed strictly and little or no tweaking is done at both ends. Many a times its noticed that at-least one party needs to tweak the standard connectivity.