“Providing the standards that cover a broad spectrum of use cases, the use of FHIR APIs coupled with an API provider that uses a rigorous privacy and security compliance process, as well as performance testing for its APIs allows the secure and trustworthy use of APIs to create the type of experiences driven by the shift to a value-based model,” says Gautam M Shah, VP Platform and Marketplace, Change Healthcare in an exclusive interview with EnterpriseTalk.
ET Bureau: Even though most executives agree on the critical nature of APIs in the enterprise ecosystem, only a few are exploiting it at scale. Why?
Gautam M Shah: While nearly every industry has benefited from the potential that APIs bring into the marketplace, U.S. healthcare is behind this trend. In U.S. healthcare, health leaders are noticing APIs play a vital role in solving long-standing—even once intractable—challenges.
While an overwhelming majority (9 in 10) of research respondents were in agreement that widespread API maturity is on the verge of reshaping healthcare according to Change Healthcare research titled The State of Healthcare APIs, there are a variety of barriers to API adoption across payers, providers and healthcare technology companies.
One reason that many healthcare organizations are not using APIs is related to industry complexity, and the industry’s use of sensitive and protected individual health data. Until recently, there have not been natural business incentives for information sharing across healthcare stakeholders, and there are a number of players involved in a single patient’s care delivery. API maturity is dependent on having the need to create a more seamless healthcare experience, and natural roadblocks have slowed information sharing across the healthcare ecosystem.
While providers note security and cost concerns as the top barriers to API adoption in their organizations, payers cite technical infrastructure, lack of industry standards and privacy concerns as the biggest barriers to adoption. Most healthcare technology companies say they wrestle with infrastructure challenges, a skills gap or security concerns. In short, while survey respondents recognize that the mature use of APIs hold value, the industry hasn’t taken the plunge due, in part, to the sensitivity surrounding healthcare data, and the inherent complexities of U.S. healthcare’s dataflow.
Recent rules from federal governing bodies, the Centers for Medicare & Medicaid Services and Office of the National Coordinator for Health Information Technology, are a major step forward to mandate the use of APIs to enhance data sharing in order to improve the overall patient healthcare journey through a common standard, FHIR, for APIs. While the quest for healthcare interoperability has been long-drawn-out, we are beginning to see results.
ET Bureau: How can healthcare providers align on barriers to address the API adoption issue?
Gautam M Shah: Standardized APIs represent a common language framework that disparate players across the healthcare ecosystem can use to ultimately facilitate meaningful exchanges, but healthcare is a large, complex industry with a myriad of interactions, transactions and diverse business needs across multiple locations.
Across nearly 400 survey respondents, provider organizations – hospitals, healthcare systems and physician groups – are leading the way in using APIs at scale as both producers and consumers, compared to payer and healthcare technology company counterparts.
While there is an overarching alignment on the challenges that exist to scale use of APIs – security, technical infrastructure, and HIPAA compliance to name a few – it is interesting to note that providers do expect to increase their investment in APIs this year. To do so effectively, they should seek a technology partner that offers a broad portfolio of independent APIs that work across multiple platforms, technologies, EHRs and customer segments while at the same time, meeting the financial, clinical and engagement needs of various stakeholders that are specific to organizational needs.
ET Bureau: How can healthcare providers deliver value-based care to their customers while ensuring the security of APIs?
Gautam M Shah: As healthcare shifts from the traditional fee-for-service model to a value-based care model – in short, compensation tied to the quality of services provided rather than the volume of procedures performed – the way that healthcare consumers engage with their care will change. Empowered by increasingly available information about their care and their care history, healthcare customers will demand the types of experiences they have elsewhere in their digital lives. Delivering these will require bringing data “to the edge” and sharing it with other providers, with other payers, and with digital health applications.
Enabling these experiences will require the use of APIs that enable the broadest set of use cases as well as to bridge the gap between disparate legacy systems. As data and the insights and experiences driven by them move to the edge, the security and privacy of the APIs, already top-of-mind as illustrated by our State of Healthcare APIs research findings, become more critical.
Providing the standards that cover a broad spectrum of use cases, the use of FHIR APIs coupled with an API provider that uses a rigorous privacy and security compliance process, as well as performance testing for its APIs allows the secure and trustworthy use of APIs to create the type of experiences driven by the shift to a value-based model.
ET Bureau: What innovative technologies will emerge in the future to derive various benefits from APIs?
Gautam M Shah: Today’s society thrives on information sharing which has made industries like retail, banking and travel companies increasingly consumer-friendly. While progress has been made across the U.S. healthcare industry, data sharing lags behind despite considerable investment over the previous decade — $26 billion since 2009. As an industry, healthcare is standing on the edge of an innovation revolution that will require healthcare organizations to embrace the use of APIs as both consumers and producers in order to achieve a more patient-centered approach to care delivery.
By and large, APIs are the building blocks to creating patient-centered healthcare that improves care, cost and overall consumer experience. Findings from the State of APIs in Healthcare research has confirmed that industry leaders believe that APIs are essential to every healthcare organization’s business strategy because of their functionality. Additionally, most payers, providers and vendors also agree that APIs improve solution quality and make patient data access “easy.” While widespread API maturity will propel the digital health economy forward, the next two years will be pivotal.
Gautam M. Shah (“G”) is Change Healthcare’s VP of Platform and Marketplace Strategy. In this role, he leads product and business transformation and advocacy aimed at creating a more operable and transparent healthcare system. Mr. Shah has successfully created and commercialized innovative clinical and operational workflow and patient experience solutions across the healthcare ecosystem as an executive-in-residence at the Center for Digital Health Innovation at UC San Francisco, as product management leader for Cisco’s portfolio of emerging healthcare products, and as general manager of Vocera’s portfolio of clinical workflow, integration, and patient experience products.