Following the ONC final rule, health IT experts from Pew Charitable Trusts laid out three API improvements that could lessen clinician burden.
The Office of the National Coordinator for Health Information Technology (ONC) final interoperability rule has the potential to transform EHR systems by improving interoperability and addressing clinician burden, according to health IT experts from Pew Charitable Trusts and American Medical Association.
Similar to how cellular phones have transformed technology and enhanced daily life for individuals, Pew explained that application programming interfaces (APIs) and enhanced interoperability mandated in the ONC final rule can have a similar positive impact on the future of EHRs.
While the ONC final rule takes a hard stance on information blocking, it also calls on medical providers and device developers to promote patient data access using third-party apps and APIs.
“Many Americans already use programs that rely on these types of interfaces, perhaps without realizing it,” Ben Moscovitch, project director for Health Information Technology at Pew; Ashley Ashworth, Pew; Matt Reid, AMA; and Laura Hoffman, AMA, wrote in a recent post. “For example, APIs are the underlying technology that enables online shopping and personal finance tracking. If broadly used in health care, they could usher in a new era for EHRs, enabling patients, clinicians, and researchers to access data in simpler, more efficient ways than they’re able to today.”
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Although the advancement of APIs in the medical field aims to empower patients by giving them increased access to their health information, APIs can also reduce clinician burden and improve patient care. Third-party apps and programs can analyze tests, inform medication selection, and enhance other clinical decisions, wrote the authors.
Clinical decision support (CDS) tools are geared towards assisting providers, especially when faced with treatment or diagnostic issues. In return, clinicians rely on APIs to access crucial data from EHRs to combat these issues.
“For example, a CDS app could incorporate the latest guidance for how to manage people with COVID-19 in various settings,” they wrote. “Ultimately, API-enabled EHRs should act more like smartphones and tablets on which apps can easily be installed and removed. To be successful, APIs can and should also provide a high level of data security and instill trust that medical records remain private and protected.”
APIs could also reduce the amount of patient data that’s shared, thus reducing unnecessary burden.
“Currently, clinicians who need specific information from a patient’s medical record—for example a vaccination history or a previous test result—may have to sort through hundreds of pages of data and notes to find what they need,” the writers explained.
“APIs, however, could allow clinicians to obtain only the precise data they need, such as a recent treatment plan from a specialist. APIs can also reduce barriers to finding and sharing data among different EHR products.”
While health professionals and government agencies are working in the right direction when it comes to APIs, Pew explained what challenges must be addressed to advance API use.
First, making MRI scans and other relevant data available through APIs would in turn improve CDS tools and give more data access to clinicians.
“That, in turn, could make CDS tools more robust and reduce duplicative tests,” the writers explained. “For example, having a scan of a patient’s lungs could help a clinician rule out specific illnesses without reordering the test or waiting hours for faxed reports.”
Next, the authors said write access, or the ability to add or edit EHR information, needs to be federally implemented. Currently, API access is read-only and until then, problems will continue for the user.
“For example, clinicians who decide to prescribe a more effective antibiotic because of a recommendation from a CDS tool have to add it into the EHR themselves,” they wrote. “The program can’t do it. This means valuable time lost and increased opportunity for error. On the other hand, when apps have the ability to edit medical records, data security must be front and center.”
“ONC, in recent rule-making, has also paved the path for write access by adding provenance, or a record of where and when specific information was entered. Knowing the origin of information and how recent it is helps maintain data quality and gives clinicians critical context.”
The third challenge that needs to be addressed are CDS Hooks. These allow EHR systems to have on-going communication and with background apps.
“For example, when prescribing an antibiotic, CDS Hooks technology may suggest launching an app to help select a medication based on a patient’s allergies, previous condition, or drug cost,” they explained. “While CDS Hooks is still in development, ONC and developers should work with clinicians and hospitals to identify gaps and assess opportunities to build confidence in its use.”
While the ONC final rule is a solid stepping stone for the future of interoperability, APIs, and information blocking, EHR developers and the federal government can take these rules to the next level.
“Now that ONC has laid the groundwork for a national health IT infrastructure based on APIs, the agency should take steps to fully leverage safe and effective tools to transform the patient and clinician experience in health care,” the writers concluded.
“EHRs contain a trove of information; the federal government should ensure, through its current regulations and future ones, that APIs can improve the sharing and use of that data in new and exciting ways.”
Source: EHR Intelligence