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Use a patient approach with healthcare APIs

With this week’s news that healthcare interoperability is getting a boost from the support of six major tech companies, it’s tempting to think that is where the breakthroughs are going to happen.

But it could be that the grass roots efforts at hundreds of hospitals around the country might be just as successful, if not more so. Take Children’s Hospital Los Angeles, which has been using healthcare APIs to boost interoperability since 2014. The hospital’s IT team is making headway, but they would agree the struggle is real.

Like hospitals everywhere, CHLA has a mix of legacy systems, apps in the cloud and a lot of other systems that are somewhere in between. For Aaron Fry, the manager of enterprise applications, the goal is clear: free the data and get it flowing to everyone. Similar to other nascent efforts around the country, CHLA has chosen one of the widely accepted healthcare APIs – FHIR— to bring interoperability in to the hospital systems, and will use Cerner’sversion of FHIR when it comes time to look at integrating patient data or clinical information.

CHLA is no stranger to the challenges of healthcare APIs and integration. Its portal sitewas built using APIs to tie physicians in to the Cerner back end, and it’s been online since 2014. The hospital has continued to add functionality, including most recently an API from DocuSign to provide signing capabilities.

Now, though, CHLA is putting energy in to developing an API layer that will create a bridge between the older systems and new internally and externally facing applications. The hospital’s challenge is nearly universal – how to use healthcare APIs to create an organic layer that brings legacy and mobile together, and to do it quickly, securely and in a HIPAA compliant way.

Flexibility has been key. Some internal systems do have a REST APIon board (so it’s much easier), while others have required proprietary scripting languages for data extraction (making things much harder). Control of information access is also an issue. Some data needs to be accessible only on the premises, while other data is safe to view anywhere.

Not surprisingly, Fry said the biggest challenges have been around the legacy systems. His strategy has been to break down the problem in to small parts, and he has 3 to 4 of his team of 15 moving forward on an employee-facing ERP app. Using the Agile software developmentmethodology, Fry and team will show this app to the stakeholder – in this case, the MarCom department – and if it’s a go, this process could be the model CHLA uses moving forward.

Will sweeping change come from the slow but steady steps at hospitals like CHLA, or through big company, industry-driven efforts? We’re going to have to wait and see.

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