73% of Digital Health Companies Use Standards-Based EHR APIs

Most digital health companies use standards-based application programming interfaces (APIs) to support EHR integration, according to a study published in JAMIA.

The study aimed to capture digital health company experiences integrating with EHRs with new federally regulated standards-based API policies in place to advance interoperability.

Researchers fielded a national survey across digital health companies that develop tools enabling human interaction with an EHR API.  

The survey found that while most respondents use standards-based APIs to integrate with EHRs and support the use of the HL7 FHIR standard in their products, about 57 percent of respondents indicated using both standards-based and proprietary APIs to integrate with an EHR.

However, more companies reported predominantly using standards-based versus proprietary APIs, indicating that while companies needed both API types to integrate successfully, standards-based APIs were more critical.

These findings suggest that while the industry is making progress toward the use of standards-based APIs, a notable share of digital health companies continue to rely on non-standards-based APIs to some degree.

On average, companies reported that standards-based APIs required less burden than proprietary APIs to establish and maintain. However, companies reported barriers to adopting standards-based APIs, including high fees, a lack of realistic clinical testing data, and a lack of data elements of interest or value.

To improve access to standards-based API integration, companies recommended that federal policy support cost controls, testing and validation, and an expanded set of data elements.

“Further private sector support and federal policy are needed to ensure APIs are available to reduce barriers to entry and nurture competition ‘without special effort,’” the study authors wrote.

Results indicate an opportunity for industry and ONC to gain input on high-value use cases not currently adopted in the United States Core Data for Interoperability (USCDI) standard and standards-based APIs.

“The results show that an iterative and inclusive approach that incorporates industry feedback (not just EHRs, but the digital health and app developer community, too) can help push the technical and functional properties of standards-based APIs forward and in step with developer needs,” the authors said.