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By Alsten Tauro

A few weeks ago, OPEN MINDS CEO Monica E. Oss asked an important question – can electronic health record (EHR) vendors prevent consumers and other provider organizations from accessing health records based on interoperability between data products (see Are EHR Vendors Holding Patient Data Hostage?)? Whether or not this is truly a matter of nefarious EHR vendor practices or the evolving “state of the art”, it still remains that a major cause of interoperability in health care is that software systems are often “enterprise-based,” and not built to communicate with other software systems.

This is where “open” application program interfaces (API) could come into the picture (for an introduction to API, see my article, APIs & Why You Should Know What They Are. Open API (also referred to as “public API”) is software released to the public that supports compatibility between design applications and products. In theory, this could make it possible for EHRs to interface (and share data) with many different applications – advocates are calling for data in proprietary EHRs to be released for use by health information exchange and analysis, and applications running on mobile devices (see API Adoptions Rise As Data Silos Fall). Here are two large movements in open API advocacy to keep an eye on.

Substitutable Medical Apps & Reusable Technology (SMART) – This initiative is led by Harvard Medical School in collaboration with Children’s Hospital Boston, Partners Healthcare, the Regenstrief Institute, the University of Texas, and the University of Wisconsin; and is developing Apps that can use data from electronic health records, with two program goals:

  1. Develop a user interface which allows “iPhone-like” substitutability for medical apps based upon shared basic components.
  2. Create a set of services that enables efficient data capture, storage, retrieval and analytics, which are scalable to the national level and respectful of institutional autonomy and patient privacy.

In the Forbes article, Who’s Who Of Health Care Join Forces For SMART Technology, Dr. Ken Mandl of Boston Children’s Informatics Program describes this as, “The opportunity…to create an ‘app store’ to extend the capabilities of EHRs.” This would allow for innovators to develop an app for any system, and health IT users to customize their systems with these new apps, instead of adopting whole new systems (for more on SMART, check out SMART Health IT and Substitutable Medical Apps, Reusable Technologies).

JASON – This independent group of scientists has advised the U.S. government on matters of science and technology (not limited to health care) since 1960. In 2014, this group put out the report, Data For Individual Health, which advocated for;

[T]he establishment of publicly available APIs to bridge from existing systems to a future software ecosystem that can ingest, protect, integrate, and share the knowledge gained from the vast stores of data…. making the installed base of 140 million smartphones a natural platform for collection, assimilation, and exchange of EHR and PHR data.

This group recommends that the U.S. Department of Health and Human Services should adopt policies supporting open API standards, and incentivize EHR vendors to develop and adopt standards to support API.

Whether these movements get us closer to the goal of a strong health information exchange system (or even if their solutions are the correct solutions) remains to be seen. For more, join the OPEN MINDS team in Washington, D.C. on October 27 for The OPEN MINDS Technology & Informatics Institute session, How Can We Improve Behavioral Health Data Exchange? The Challenges & The Opportunities Of HIE.

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