How APIs Are Streamlining Healthcare Art Anthony April 22, 2016 Managing healthcare records can be a painful experience, for both patients and doctors. Though extensive medical records are kept on patients to be made available to new caregivers, accessing them is not always an easy process. In the UK, records are held digitally (usually General Practice (GP) records) yet some are still written by hand (details of hospital visits, etc.). And just to make matters even more complicated, the same data types are at times held partly digitally and partly manually. While online access to GP records is free, UK citizens can expect to pay up to £50 for a hard copy of their medical files. And we haven’t even begun to talk about the additional charges for sick notes, copies of immunization records, and documents for insurance companies. All of which might well get you wondering, “isn’t there a better way?” In a word, yes. Why Healthcare Needs APIs As it stands today, across the world there are woeful inefficiencies in even the most developed and effective healthcare services. Take this example experience: Patient A reports to the doctor with fatigue. They are booked in for a blood test which they attend. They hear nothing back about it so call their local doctors’ surgery. The secretary can tell them that their results are fine but nothing beyond that. Another blood test appointment is booked. They have to call for results again only to find that the test came back with no conclusive results. Patient A reports to a specialist in the meantime who requires another blood test, only for Patient A to later find out that they are testing for the same thing as the first blood test they went in for. Already you can see the problem here (aside from our patient running out of blood): people and/or systems aren’t communicating properly, which leads to wasted resources and wasted time. It would be easy to write this off as “just how it goes,” but given that we already know that getting systems to talk to each other is something that APIs can do very well, we’re glad to see that they are finally being integrated into the healthcare space. Into impressive tech? Check out 20+ Emotion Recognition APIs That Will Leave You Impressed, and Concerned Using APIs for Diagnosis ApiMedic is an interesting service that provides a symptom checker patients can use to get an idea of what they might be suffering from. Of course, there’s nothing particularly new about that; everyone now uses a combination of WebMD and Google to find out what their symptoms mean. What’s interesting is the way in which ApiMedic is being used by hospitals around the world. Developers at Istanbul University Hospitals, for example, have embedded the system on their website to allow patients to book an appointment with the correct specialist. While it’s true that there is a risk associated with relying on a patient’s initial judgement, it’s something that will almost certainly be required as more pressure builds on the healthcare industry. But it isn’t just patients who can use APIs for diagnosis. To make quicker, easier and more definitive diagnoses, doctors need the most complete EHR (electronic health records) data that they can get their hands on. Doctrly provides an open API for EHR that professes to deliver nearly real-time EHR data to apps built using the system. Doctors often complain about sluggish systems that, even when they do finally produce the requested information, give them incomplete data. It appears that APIs could be a valuable tool for improving efficiency and coming up with diagnoses more quickly, for both patients and doctors, which could have important implications when a few minutes could mean the difference between life and death. Improving Clarity for Patients One of the biggest problems in the healthcare industry is communication between patients and doctors. Doctors often use terminology that’s unfamiliar to patients and whether it’s due to embarrassment or information overload, patients don’t always stop to make sure that they know everything they need to. MedlinePlus Connect is a service, developed by the National Institute of Health and showcased by the U.S. National Library of Medicine, that “converts” diagnosis, medication, and lab test codes into a simple text description. Clearly this is useful for doctors as it means that, provided they have all their codes down pat, they can convert technical shorthand into plain English. However, there are also ways in which this could also be very useful for patients. Rather than trying to memorize all test results, diagnoses, or the medication they need (for when they’re trying to relay them to other doctors, chemists or even family members), they could tap a few codes into an app to get a detailed breakdown of the issues in language that they can understand. Another indirect advantage of using APIs is that it potentially facilitates an easier and more intuitive interface through which patients can access their results. Jay Manciocchi, writing for Mashery, suggests the following use of healthcare APIs: Although seasoned developers are used to APIs with long names that feature a challenging list of requirements, modern APIs tend to use web-friendly approaches, which are best known as RESTful (REpresentational State Transfer) and SOA (Service Orientated Architecture) architectural approaches. In healthcare settings, these APIs allow you to pull-up a web browser and type in a location like this to get some lab results: https://ABCclinic.org/patients/John_Doe/labs/glucose_test/ If you’ve ever had to use an outdated web portal to access test results or make an appointment, you’ll already know that they’re rarely as simple as that hypothetical web address listed above. Making Operations Easier for Health Professionals As well as making things easier for patients, there are APIs out there that are changing the way doctors and other healthcare professionals run their business. Drchrono, for example, provides an API and SDK to help doctors manage their practice, bill their patients, and handle electronic health records in one place. And, even though we have no experience using it, it’s worth pointing out that it looks a heck of a lot nicer than anything we’ve ever seen doctors using: Source – Drchrono Because Drchrono places such emphasis on the importance of their developer program, they have a range of featured partners who integrate with their services. Among these are an electronic stethoscope attachment called Eko, an app that fills cancellations automatically called QueueDr and a self-scheduling system called NextPatient. Until recently, a big issue has been that doctors have had to use multiple systems to manage their practice, make appointments, bill patients and so on. As a result, the process was fractured because it needed to be carried out on a number of different platforms. Two things in play right now are solving that problem: “One stop shop” services that are capable of handling several different elements of running/managing a practice. More API-driven apps that integrate with a core system. Previously a service might integrate with, say, a practice’s billing system but not its appointment functions. This doesn’t necessarily mean that the service is totally useless, but it does impose limitations on how effective it can be. As services like Drchrono, which take a more holistic and programmable approach to running a doctor’s office begin to emerge, so does the possibility of integrating other services to make the whole process quicker and more effective. What industry will APIs disrupt next? Check out Sectors for Exploitation with APIs The Trouble with Using APIs in a Healthcare Setting In the UK, and elsewhere in the world, the healthcare services are publicly funded. While you might expect this to mean that efficiency and cost-effectiveness would be of paramount importance, the opposite is often true…as is often the case with open data government initiatives. Where public money is concerned, it’s usually a case of “if it ain’t broke, don’t fix it.” Even though many, like Kenneth Mandl and Isaac Kohane, argue that actually it is broken: This myth continues to justify soaring IT costs, burdensome physician workloads, and stagnation in innovation—while doctors are becoming increasingly bound to documentation and communication products that are functionally decades behind those they use in their ‘civilian’ life. Crucially, they also argue that “a few companies controlling much of the market remain entrenched in ‘legacy’ approaches, threatening other vendors’ viability.” However, things can’t remain the same forever, and we’re finally starting to see the healthcare industry begin to embrace new technology. In their article on the untapped potential of APIs in the healthcare space, Harvard Business Review identified four main needs to accelerate their adoption: Obvious financial incentives to encourage data exchange Address privacy and security concerns, which is an ongoing concern for anyone transmitting data using the cloud Development of industry standard APIs with transparent costs Deal with issues relating to culture, such as the fear of losing control, patient-doctor relations, and workflow Provided pilots and policies continue to be lined up to tackle these issues, there’s no reason why we won’t see even wider adoption of APIs and other technological advances to shake up the healthcare space. Making Things Easier for Researchers Writing for Mashery, Jay Manciocchi points out another benefit — this time an indirect one — that APIs in the healthcare space offer: Modern APIs also offer the standardization of data. Each field must use consistent units and terminology, which can be challenging, given the information found in most healthcare records…Clinical decision support, public health, and research depend on quantifiable data, which APIs lead to. If anything is going to speed up the adoption of APIs and the Internet of Things (IoT) in the healthcare space, this is it. Successful research leads to pilots, which leads to results, which leads to progress. Along the way, most of these activities also generate funding. If we’re really going to get cynical about it, the financial impact that using APIs in the healthcare space has on potential funding opportunities is one of the key reasons people and organizations will be more open to adopting them. The Future of Healthcare and APIs The most exciting thing about APIs in relation to healthcare is that they suggest a time, maybe not too far from our own, in which patient information is truly joined up. Imagine an ambulance arriving on the scene of a car crash and being able to see their entire medical history. No more need to check for medic alert bracelets, organ donor cards, or evidence of pacemakers and allergies. Medics will instantly know that they need to be extra careful moving them because of a chronic back pain condition and that they can’t give the patient any morphine because they reacted badly to it during a previous hospital stay. But how, and where, is all of that data stored? Several experts have suggested blockchain technology as a potential solution, with decentralized electronic health records available to all healthcare services that require it. Healthcare expert Peter Nichol suggests that that each patient would be provided with a code and an address to unlock their data and enable access, with contributors to records being provided with another signature that combines with the patient’s hash to authenticate their own access. All of which sounds just as, if not more, secure than the current system. It’s true that a world of more freely accessible healthcare data comes with plenty of worries of its own – such as how to make sure that confidential medical records never fall into the hands of employers, journalists or even unauthorized family members. Other risks arise with the involvement of healthcare startups that may not abide by proper protocols, as is the case with Theranos, the blood testing startup now under investigation. Provided that the API space can negate these concerns, making healthcare more programmable will come with limitless possibility for progress, growth, and overall social welfare.