[{"innerBlocks":[],"name":"core\/freeform","postId":1243,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"With the federal government\u2019s call for adoption of standardized application programming interfaces, the industry could be poised to move towards a healthcare API economy.

An ecosystem of third party API-enabled apps, running on smartphones and other mobile devices, is envisioned by the Department of Health and Human Services as dramatically increasing consumer access to their electronic health records and other healthcare data.

Also See:<\/b> Why \u2018the year of the API\u2019 will pose big challenges for providers<\/a>

\u201cAlthough the app universe now has over 2 million products, it is nevertheless very difficult to get your personal medical data on your phone\u2014but this is about to change,\u201d according to National Coordinator for Health IT Don Rucker, MD.

On Monday, the Office of the National Coordinator for HIT released a proposed rule\u2014for the first time\u2014requiring HL7\u2019s Fast Healthcare Interoperability Resources as the standard to which developers must certify their APIs.

In addition, the Centers for Medicare and Medicaid Services on Monday made public its own proposed rule requiring that all health plans doing business in Medicare, Medicaid and through the federal exchanges share claims and other health information with patients electronically via an API by 2020.

\u201cThe foundation of our API economy is trust and standards\u2014it was with that in mind that we started working on FHIR to bring the web economy to healthcare,\u201d observed Graham Grieve, HL7\u2019s FHIR product director, who spoke Thursday at the HIMSS19 conference in Orlando.

FHIR, which is based on modern internet conventions, has been widely embraced by app developers, health IT vendors and providers to help solve the interoperability challenges confronting the healthcare industry. In addition, large consumer tech companies such as Apple and Microsoft are supporting FHIR and implementing it into their products to bring the API economy to healthcare.

Stan Huff, MD, chief medical informatics officer at Intermountain Healthcare, says he \u201creally likes the addition of the FHIR API as a requirement\u2014a lot of people have already gone that way, and having it become part of regulation will help to move quicker to implement it and put more resources behind it.\u201d

\u201cIt\u2019s generated incredible interest and involvement across the industry, and the reason is really simple\u2014because it enables an API economy,\u201d said Grieve. \u201cAPIs drive costs down. This is fundamentally an economic driver. By leveraging the web, we have stable and robust information handling techniques, and wide availability of developers and libraries.

\u201cMost importantly, the web has shown how to build communities\u2014and the web economy builds on communities as much as on technologies,\u201d added Grieve. \u201cBut, in spite of all those things, healthcare has remained hard.\u201d

However, with ONC\u2019s proposed rule, he contends that the industry is \u201cnow at an inflection point in the entrenchment process.\u201d

Last month, HL7 announced the publication of FHIR Release 4, the normative version of the emerging interoperability standard. However, in its proposed rule, ONC wants to make FHIR Release 2 a requirement. Although the agency required FHIR Release 2, ONC has asked for public comment on their proposed rule, and Grieve predicts it \u201cwill get a lot of strong comments on that.\u201d

Nonetheless, Huff says \u201cit wouldn\u2019t be a bad thing to have experience with FHIR Release 4 before it becomes regulation.\u201d He adds that one of the challenges with standards is \u201cyou need some way to elegantly move from version to version\u201d and \u201cbeing able to move seamlessly from version to version without causing a lot of challenges for implementers.\u201d

Rasu Shrestha, MD, chief strategy officer at Atrium Health, is leading the Department of Veterans Affairs\u2019 Open API Pledge initiative, which calls on providers to support current and future versions of FHIR. As part of the effort, provider organizations are voluntarily collaborating with the VA to map health data to industry standards.

\u201cThe economic drivers that got us providers to where we are today was driven primarily by the fact that there were these proprietary standards that vendors really were pushing forward,\u201d said Shrestha during a panel session at HIMSS19.

However, Janet Campbell, vice president of patient experience and research and development relations at Epic, pointed out that her company was a founding member of the Argonaut Project, an industry-wide effort to accelerate the development and adoption of FHIR.

\u201cAs much as this might be a surprise to people, both we and Cerner\u2014and all the other major vendors out there\u2014really do care a lot about standards-based development,\u201d commented Campbell. \u201cIt\u2019s why we\u2019ve been participating in organizations like HL7 for so long.\u201d

Still, Shrestha believes that healthcare market conditions are ripe for change and that a \u201ccoalition of the willing\u201d is pushing for open standard APIs.

Jocelyn Keegan, project manager for the Da Vinci Project, a payer-provider led initiative to leverage FHIR to exchange critical data required for value-based care delivery, sees healthcare insurers starting to adopt the standard.

\u201cIf you think about our market in general, there are always folks that are the advancers doing the new technology\u2014the latest things,\u201d said Keegan. \u201cOn the provider-provider and provider-patient side, they are a year or two ahead. But, I\u2019m still gobsmacked at the force with which the payer community has joined Da Vinci and been joining HL7 over the last eight to nine months.\u201d

According to Shrestha, the promise of the API economy is for healthcare to finally catch up with other industries in focusing on the \u201cexperiential layer\u201d of providing care\u2014in the same way that consumer apps enable easy online banking, shopping, and travel services, among others.

\u201cIn our proposed rule, we propose to adopt FHIR as the standard to which developers must certify their APIs and propose language to support an ecosystem for the secure flow of information,\u201d according to ONC\u2019s Rucker. \u201cWe believe this approach could lead to industry standard interfaces\u2014interfaces where app developers can develop effective apps that use API technology without special effort to access a patient\u2019s data.\u201d

\u201cIf you create a single language and create convergence in the community around the single API, then there\u2019s all sorts of ways to leverage that,\u201d concluded Grieve. \u201cIf you get everybody in this one place, then you get benefits, often in multiple directions.\u201d
","saveContent":"With the federal government\u2019s call for adoption of standardized application programming interfaces, the industry could be poised to move towards a healthcare API economy.

An ecosystem of third party API-enabled apps, running on smartphones and other mobile devices, is envisioned by the Department of Health and Human Services as dramatically increasing consumer access to their electronic health records and other healthcare data.

Also See:<\/b> Why \u2018the year of the API\u2019 will pose big challenges for providers<\/a>

\u201cAlthough the app universe now has over 2 million products, it is nevertheless very difficult to get your personal medical data on your phone\u2014but this is about to change,\u201d according to National Coordinator for Health IT Don Rucker, MD.

On Monday, the Office of the National Coordinator for HIT released a proposed rule\u2014for the first time\u2014requiring HL7\u2019s Fast Healthcare Interoperability Resources as the standard to which developers must certify their APIs.

In addition, the Centers for Medicare and Medicaid Services on Monday made public its own proposed rule requiring that all health plans doing business in Medicare, Medicaid and through the federal exchanges share claims and other health information with patients electronically via an API by 2020.

\u201cThe foundation of our API economy is trust and standards\u2014it was with that in mind that we started working on FHIR to bring the web economy to healthcare,\u201d observed Graham Grieve, HL7\u2019s FHIR product director, who spoke Thursday at the HIMSS19 conference in Orlando.

FHIR, which is based on modern internet conventions, has been widely embraced by app developers, health IT vendors and providers to help solve the interoperability challenges confronting the healthcare industry. In addition, large consumer tech companies such as Apple and Microsoft are supporting FHIR and implementing it into their products to bring the API economy to healthcare.

Stan Huff, MD, chief medical informatics officer at Intermountain Healthcare, says he \u201creally likes the addition of the FHIR API as a requirement\u2014a lot of people have already gone that way, and having it become part of regulation will help to move quicker to implement it and put more resources behind it.\u201d

\u201cIt\u2019s generated incredible interest and involvement across the industry, and the reason is really simple\u2014because it enables an API economy,\u201d said Grieve. \u201cAPIs drive costs down. This is fundamentally an economic driver. By leveraging the web, we have stable and robust information handling techniques, and wide availability of developers and libraries.

\u201cMost importantly, the web has shown how to build communities\u2014and the web economy builds on communities as much as on technologies,\u201d added Grieve. \u201cBut, in spite of all those things, healthcare has remained hard.\u201d

However, with ONC\u2019s proposed rule, he contends that the industry is \u201cnow at an inflection point in the entrenchment process.\u201d

Last month, HL7 announced the publication of FHIR Release 4, the normative version of the emerging interoperability standard. However, in its proposed rule, ONC wants to make FHIR Release 2 a requirement. Although the agency required FHIR Release 2, ONC has asked for public comment on their proposed rule, and Grieve predicts it \u201cwill get a lot of strong comments on that.\u201d

Nonetheless, Huff says \u201cit wouldn\u2019t be a bad thing to have experience with FHIR Release 4 before it becomes regulation.\u201d He adds that one of the challenges with standards is \u201cyou need some way to elegantly move from version to version\u201d and \u201cbeing able to move seamlessly from version to version without causing a lot of challenges for implementers.\u201d

Rasu Shrestha, MD, chief strategy officer at Atrium Health, is leading the Department of Veterans Affairs\u2019 Open API Pledge initiative, which calls on providers to support current and future versions of FHIR. As part of the effort, provider organizations are voluntarily collaborating with the VA to map health data to industry standards.

\u201cThe economic drivers that got us providers to where we are today was driven primarily by the fact that there were these proprietary standards that vendors really were pushing forward,\u201d said Shrestha during a panel session at HIMSS19.

However, Janet Campbell, vice president of patient experience and research and development relations at Epic, pointed out that her company was a founding member of the Argonaut Project, an industry-wide effort to accelerate the development and adoption of FHIR.

\u201cAs much as this might be a surprise to people, both we and Cerner\u2014and all the other major vendors out there\u2014really do care a lot about standards-based development,\u201d commented Campbell. \u201cIt\u2019s why we\u2019ve been participating in organizations like HL7 for so long.\u201d

Still, Shrestha believes that healthcare market conditions are ripe for change and that a \u201ccoalition of the willing\u201d is pushing for open standard APIs.

Jocelyn Keegan, project manager for the Da Vinci Project, a payer-provider led initiative to leverage FHIR to exchange critical data required for value-based care delivery, sees healthcare insurers starting to adopt the standard.

\u201cIf you think about our market in general, there are always folks that are the advancers doing the new technology\u2014the latest things,\u201d said Keegan. \u201cOn the provider-provider and provider-patient side, they are a year or two ahead. But, I\u2019m still gobsmacked at the force with which the payer community has joined Da Vinci and been joining HL7 over the last eight to nine months.\u201d

According to Shrestha, the promise of the API economy is for healthcare to finally catch up with other industries in focusing on the \u201cexperiential layer\u201d of providing care\u2014in the same way that consumer apps enable easy online banking, shopping, and travel services, among others.

\u201cIn our proposed rule, we propose to adopt FHIR as the standard to which developers must certify their APIs and propose language to support an ecosystem for the secure flow of information,\u201d according to ONC\u2019s Rucker. \u201cWe believe this approach could lead to industry standard interfaces\u2014interfaces where app developers can develop effective apps that use API technology without special effort to access a patient\u2019s data.\u201d

\u201cIf you create a single language and create convergence in the community around the single API, then there\u2019s all sorts of ways to leverage that,\u201d concluded Grieve. \u201cIf you get everybody in this one place, then you get benefits, often in multiple directions.\u201d
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Proposed rules from HHS open door to healthcare API economy

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