No (Useful) Innovation without EMR Integration

By: Jeremy Pierotti

A recent Healthcare IT News article highlighted John Halamka, MD, CIO of Beth Israel Deaconess Medical Center, and his discussion of the need for personalized treatment plans. Halamka suggests we must integrate care planning and clinical pathways tools with EHRs, and that FHIR services can enable connections with these third-party applications. He notes this will "reduce errors and cost, include appropriate peer-rated evidence and result in clear action for the care team."

The challenge is that each of the EMR vendors have implemented their own set of APIs. The APIs perform differently in each environment, and meaningful gaps exist between EMR platforms. If you are a digital health vendor with a great application, this means you will need to write your application differently for each one of those EMRs. Additionally, those EMR vendors are going to charge their customers, you, or both you and their customers (!), for using those API hooks. Yes, you are able to do some activity, but are limited to the APIs that those vendors make available to you. 

I’ve had opportunities to speak with Dr. Halamka personally, and I always learn from him. His comments on workflow integration align with the writings of my colleague Dave Levin, MD. Digital health solutions bring value when embedded in end user workflows. Force a new process, and the value declines significantly.

Earlier this year, Dr. Halamka and I discussed web services defined by the FHIR specification. I noted that FHIR services are being implemented differently by each EMR vendor. Dr. Halamka added that FHIR services will support certain basic workflows, but if you want sophisticated automation of complex processes today, your EMR integration will need a robust library of flexible APIs. For example, what if your real-time clinical surveillance application needs all medication orders from the ICU in the past 15 minutes? What if your device rep scheduling app needs complex OR schedule info not available via a standard Encounters API or SIU interface? And, what if your implementation team (whether 2 or 200 FTEs) just cannot scale if custom integrations are needed for each customer?

That’s where other API tools add value. A universal, powerful API that works across major EMRs allows digital health innovators to focus on building great products, not painful EMR integrations. And by leveraging advanced APIs – built to streamline today’s complex workflows – innovators rapidly solve their customers’ multifaceted, real-world challenges.

Better care planning tools, and other specialized software, demand that we remove the barrier of integrating with EMRs. Digital health innovators are finding that robust, proven API platforms make selling and implementing great solutions a whole lot easier.

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